• Title/Summary/Keyword: Chemotherapy

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The Economic Evaluation of Outpatient-chemotherapy administration model (외래 항암 화학요법 주사실 모델의 적정성 분석)

  • Song, Jung Hup
    • Quality Improvement in Health Care
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    • v.11 no.1
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    • pp.16-30
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    • 2004
  • Background: Although the number of cancer patients increase, the resources for cancer management are not increased. If the outpatient chemotherapy administration room is operated, the shift of patients from inpatient 10 outpatient is occurred. So the capacities for chemotherapy increased and the shifted rooms were occupied with new non-chemotherapy patients. The income of the hospital increased. The purpose of this study was to assess usefulness and cost-effectiveness of the outpatient-chemotherapy adminstration model. Method: There are six beds, two chairs and two nurses and one personnel in the outpatient chemotherapy room. The satisfaction study by patients/family and doctors and the cost analysis over 12 months, by comparing costs of chemotherapy administration at outpatient chemotherapy room with inpatient at ward and inpatient-nonchemotherapy at ward were done. Results: The 97.1 percent of patients/family and the 94.4 percent of doctor who involved chemotherapy were satisfied with outpatient chemotherapy administration. The 91.7% of doctors said there were no differences in treatment outcome between outpatient and inpatient chemotherapy administration. The average number of patients in outpatient chemotherapy room increased from 10.7 to 15.4 but in inpatient from 19.4 to 18.3. The average number of inpatient chemotherapy were not changed related to increase of the average number of outpatient chemotherapy. The profit between outpatient chemotherapy and inpatient chemotherapy administration was 45,344,710 won and the profit between outpatient chemotherapy and non chemotherapy treatment was -185,294,614 won. Conclusion: The outpatient chemotherapy administration model is good for patients/family, doctors and hospital partially. But the hypothesis described above was not correct. The process of cancer patients treatment were from diagnosis and treatment to first administration of chemotherapy. So the shift from inpatient to outpatient was not occurred. In economic aspect, the profit between outpatient chemotherapy and non chemotherapy treatment was in the red. As the level of health care fees was so low, the hospitals hesitate operating the room of outpatient chemotherapy. It is necessary to raise the level of health case fees for outpatient chemotherapy administration.

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The Prognostic Significance of Compliance with Postoperative Adjuvant Chemotherapy in Patients with Stage III Gastric Cancer: an Observational Study

  • Jang, Sung Ho;Jung, Young Jae;Kim, Min Gyu;Kwon, Sung Joon
    • Journal of Gastric Cancer
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    • v.18 no.1
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    • pp.48-57
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    • 2018
  • Purpose: Postoperative adjuvant chemotherapy is usually prescribed to improve the survival of patients with advanced gastric cancer who undergo curative surgery. This study was designed to determine the impact that the degree of compliance with chemotherapy has on the prognosis of patients with gastric cancer. Materials and Methods: Among 252 patients with stage III gastric cancer who underwent curative surgery between July 2004 and December 2014, 85 patients were postoperatively treated with S-1, the oral fluoropyrimidine derivative, 23 received no chemotherapy, and 144 received other regimens. Overall survival was compared between the complete compliance group (who received 8 cycles of S-1 chemotherapy, n=44) and the incomplete compliance group (who received less than 8 cycles of S-1 chemotherapy, n=41). Factors that influenced patient compliance with chemotherapy were also analyzed. Results: The overall 5-year survival rate was significantly different between the complete chemotherapy and incomplete chemotherapy groups (80.0% vs. 42.7%, P<0.001). Based on univariate and multivariate survival analyses of patients who received S-1 chemotherapy, the independent prognostic factors were tumor, node, and metastasis (TNM) stage (IIIa vs. IIIb vs. IIIc) and compliance with chemotherapy. TNM stage and age are significant factors that influence compliance with chemotherapy. Conclusions: TNM stage and compliance with chemotherapy are independent prognostic factors in patients with stage III gastric cancer who received postoperative chemotherapy. TNM stage and age are significant factors that influence patient compliance with chemotherapy.

Clinical Safety of Chemotherapy for Elderly Cancer Patients Complicated with Hypertension

  • Qian, Ya-Dong;Xu, Xu;Wang, Lin;Huang, Xin-En
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9875-9877
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    • 2014
  • Objective: To access the safety of chemotherapy for elderly cancer patients complicated with hypertension. Methods: Elderly cancer patients who were complicated with hypertension and treated by chemotherapy were recruited. All patients were treated by chemotherapy after an intervention on hypertension by psychotherapy, exercise guidance, salt regulation and nutrition support, therapy on hypertension, as well as prevention on hypertension associated complications. Results: In 68 eligible patients, two suspended chemotherapy because of adverse reactions and 4 because of disease progression. The remaining 62 patients completed chemotherapy smoothly based on good hypertension control. Conclusion: With effective control of blood pressure, chemotherapy for elderly cancer patients complicated with hypertension is generally safe.

Influencing Factors on Medication Adherence in Colorectal Cancer Patients Receiving Oral Chemotherapy (대장암 환자의 경구용 항암제 복용이행과 영향요인)

  • Kim, Jeong-Hye
    • Asian Oncology Nursing
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    • v.12 no.3
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    • pp.213-220
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    • 2012
  • Purpose: The purpose of this study was to identify factors that influence medication adherence in colorectal cancer patients receiving oral chemotherapy. Methods: One hundred and nine colorectal cancer patients receiving oral chemotherapy were recruited in the cross-sectional survey design. A survey including medication adherence, knowledge about chemotherapy, self-efficacy, depression and symptom experience were completed. Results: The level of medication adherence was $7.38{\pm}.80$. Medication adherence showed significant differences according to perceived health status and combination of IV chemotherapy. Medication adherence was significant correlated with self-efficacy, depression and symptom experience. On stepwise regression analysis, the most important factors related to the medication adherence were symptom experience, perceived health status and combination of IV chemotherapy. These variables explained 17% of medication adherence. Conclusion: The level of medication adherence in colorectal cancer patients receiving oral chemotherapy was relatively high. It is important to develop nursing intervention for medication adherence in colorectal cancer patients that focus on symptom experience and to consider about perceived health status and combination of IV chemotherapy.

The Trajectory of Fatigue and Quality of Life in Stomach Cancer Patients Receiving Chemotherapy (위암환자의 항암 화학요법에 따른 피로와 삶의 질 변화 양상)

  • 양영희
    • Journal of Korean Academy of Nursing
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    • v.32 no.4
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    • pp.482-491
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    • 2002
  • This study aimed to identify the change patterns of fatigue and quality of life during consecutive chemotherapies and to determine the relationship of these two variables. Method: Stomach cancer patients receiving chemotherapy were recruited from a university hospital in Seoul. Each chemotherapy, subjects were asked to respond to the questionnaires regarding their fatigue and quality of life. The number of subjects who completed 4 cycles and over was 11. Fatigue was measured with Lee's tool(1999). Quality of life was measured with a tool revised by the author based on Padilla et al(1983). Result: Most patients were in 1st stage(5 patients) or 3rd stage(5 patients). Fatigue was revealed at its highest level in the 3rd or 4th chemotherapy and at its lowest level in the 1st or 6th chemotherapy. A quality of life appeared at its highest level in the 5th or 6th chemotherapy and the lowest level in 3rd or 4th chemotherapy. Conclusion: Among 6 cycles of chemotherapy, in 3-4th chemotherapy the fatigue was the highest and the quality of life were the lowest. Many patients decided to stop treatment at the same period. Therefore we can recognize cancer patients receiving chemo- therapy are in the highest risk at the time of the 3-4 th chemotherapy.

Clinical Study on Safety and Efficacy of Qinin® (Cantharidin Sodium) Injection Combined with Chemotherapy in Treating Patients with Gastric Cancer

  • Zhan, Yi-Ping;Huang, Xin-En;Cao, Jie;Lu, Yan-Yan;Wu, Xue-Yan;Liu, Jin;Xu, Xia;Xu, Lin;Xiang, Jin;Ye, Li-Hong
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4773-4776
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    • 2012
  • Objectives: To assess the efficacy, side effects, and the impact on quality of life with $Qinin^{(R)}$ (Cantharidin sodium) injection combined with chemotherapy for gastric cancer patients. Method: A consecutive cohort of 70 patients were divided into two groups: experimental group with cantharidin sodium injection combined with chemotherapy, while the control group received chemotherapy alone. After more than two courses of treatment, efficacy, quality of life and side effects were evaluated. Results: The response rate of experimental group was not significantly different from that of the control group (P>0.05), but differences were significant in clinical benefit response and KPS score. In addition, gastrointestinal reactions and the incidence of leukopenia were lower than in the control group (P<0.05). Conclusions: $Qinin^{(R)}$ (Cantharidin sodium) injection combined with chemotherapy enhances clinical benefit response, improving quality of life of gastric cancer patients and reducing side effects of chemotherapy. Thus $Qinin^{(R)}$ (Cantharidin sodium) injection deserves to be further investigated in randomized control clinical trails.

Role of Neoadjuvant Chemotherapy in the Management of Advanced Ovarian Cancer

  • Zhao, Dan;Wu, Ling-Ying;Wang, Xiao-Bing;Li, Xiao-Guang
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.6
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    • pp.2369-2373
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    • 2015
  • Objective: To analyze efficacy of neoadjuvant chemotherapy for advanced ovarian cancer. Materials and Methods: A total of 107 patients with advanced ovarian cancer undergoing cytoreductive surgery were divided into a neoadjuvant chemotherapy group (n=61) and a primary debulking group (n=46) and retrospectively analyzed. Platinum-based adjuvant chemotherapy was applied to both groups after cytoreductive surgery ande overall and progression-free survival times were calculated. Results: No significant difference was observed in duration of hospitalization ($20.8{\pm}6.1$ vs. $20.2{\pm}5.4$ days, p>0.05). The operation time of neoadjuvant chemotherapy group was shorter than the initial surgery group ($3.1{\pm}0.7$ vs. $3.4{\pm}0.8$ h, p<0.05). There were no significant differences in median overall survival time between neoadjuvant chemotherapy group and surgery group (42 vs. 55 months, p>0.05). Similarly, there was no difference in median progression-free survival between neoadjuvant chemotherapy group and surgery group (16 vs. 17 months, p>0.05). The surgical residual tumor size demonstrated no significant difference between initial surgery and neoadjuvant chemotherapy groups (p>0.05). Multivariate analysis showed that more than 3 cycles of regimen with neoadjuvant chemotherapy was associated with more resistance to chemotherapy compared with patients without receiving neoadjuvant chemotherapy (OR: 5.962, 95%CI: 1.184-30.030, p<0.05). Conclusions:Neoadjuvant chemotherapy can shorten the operation time. However, it does not improve survival rates of advanced ovarian cancer patients.

Safety of Brucea javanica and Cantharidin Combined with Chemotherapy for Treatment of NSCLC Patients

  • Ji, Zhu-Qing;Huang, Xin-En;Wu, Xue-Yan;Liu, Jin;Wang, Lin;Tang, Jin-Hai
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8603-8605
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    • 2014
  • Objective: To assess the safety of Brucea javanica and Cantharidin combined with chemotherapy in treating patients with non-small-cell lung carcinoma. Method: A consecutive cohort of patients with NSCLC were divided into four groups: experimental group A treated with Brucea javanica injection combined with chemotherapy; experimental group B with Cantharidin injection combined with chemotherapy; experimental group C treated with Brucea javanica and Cantharidin injection combined with chemotherapy; and the control group receiving only chemotherapy. After more than two courses of treatment, safety, quality of life and side effects were evaluated. Results: The incidences of myelosuppression in groups A, B and C were lower than that in Control group (p<0.05), but without significant differences among A, B and C. Adverse effects on the gastrointestinal tract also were lower than in controls (p<0.05) without variation amnog the combined treatment groups. Conclusions: Brucea javanica or Cantharidin combined with chemotherapy could in both cases improve quality of life in our cohort of NSCLC patients without any increase in toxicity. However, further clinical experiments should be conducted to evaluate the efficacy of Brucea javanica and Cantharidin combined with chemotherapy for patients with NSCLC.

Treatment results of the second-line chemotherapy regimen for patients with low-risk gestational trophoblastic neoplasia treated with 5-day methotrexate and 5-day etoposide

  • Kanno, Toshiyuki;Matsui, Hideo;Akizawa, Yoshika;Usui, Hirokazu;Shozu, Makio
    • Journal of Gynecologic Oncology
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    • v.29 no.6
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    • pp.89.1-89.8
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    • 2018
  • Objective: Highly effective chemotherapy for patients with low-risk gestational trophoblastic neoplasia (GTN) is associated with almost a 100% cure rate. However, 20%-30% of patients treated with chemotherapy need to change their regimens due to severe adverse events (SAEs) or drug resistance. We examined the treatment outcomes of second-line chemotherapy for patients with low-risk GTN. Methods: Between 1980 and 2015, 281 patients with low-risk GTN were treated. Of these 281 patients, 178 patients were primarily treated with 5-day intramuscular methotrexate (MTX; n=114) or 5-day drip infusion etoposide (ETP; n=64). We examined the remission rates, the drug change rates, and the outcomes of second-line chemotherapy. Results: The primary remission rates and drug resistant rates of 5-day ETP were significantly higher (p<0.001) and significantly lower (p=0.002) than those of 5-day MTX, respectively. Forty-seven patients (26.4%) required a change in their chemotherapy regimen due to the SAEs (n=16) and drug resistance (n=31), respectively. Of these 47 patients failed the first-line regimen, 39 patients (39/47, 82.9%) were re-treated with single-agent chemotherapy, and 35 patients (35/39, 89.7%) achieved remission. Four patients failed second-line, single-agent chemotherapy and eight patients (17.0%) who failed first-line regimens were treated with combined or multi-agent chemotherapy and achieved remission. Conclusions: Patients with low-risk GTN were usually treated with single-agent chemotherapy, while 20%-30% patients had to change their chemotherapy regimen due to SAEs or drug resistance. The second-line regimens of single-agent chemotherapy were effective; however, there were several patients who needed multiple agents and combined chemotherapy to achieve remission.

The Relationship of Anorexia, Nausea, Vomiting, Oral Intake and Nutritional Status in Patients Receiving Chemotherapy (항암화학요법 환자의 식욕부진, 오심구토, 음식섭취량 및 영양상태와의 관계)

  • 양영희;이동선
    • Journal of Korean Academy of Nursing
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    • v.30 no.3
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    • pp.720-730
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    • 2000
  • Malnutrition is a common problem in cancer patients. In addition anticancer drugs used in chemotherapy as a major therapeutic mode are famous as the side effect like nausea, vomiting, which lead the patients to malnourished state. This study was to determine the relationship of anorexia, nausea, vomiting and oral intake and identify the influence these side effects on the nutritional status in patients receiving chemotherapy. To assess the nutritional status, anthropometry such as weight, height, body mass index(BMI), body fat proportion, and triceps skinfold thickness, and biochemistry test such as hemoglobin and lymphocyte were measured at the pre- and post- chemotherapy and the readmission time, all three times. During chemotherapy, anorexia, nausea, and vomiting using a VAS or 5-point scale and 24 hour oral intake using a food record were measured daily. Forty-nine patients knowing their diagnosis and receiving chemotherapy were recruited from an oncological ward in a general hospital for 5 months and they were reduced 31 at readmission time for a next chemotherapy. The results were as follows. Most subjects (93.6%) were in the 4th stage of cancer and 57.1% of subjects were in the first or the second chemotherapy. In most subjects(82.6%), their weight was decreased 10.7% than as usual. The degree of anorexia, nausea, and vomiting was significantly higher and the amount of oral intake was significantly less during the chemotherapy than at the pre-chemotherapy. Weight, BMI, triceps skinfold were reduced more at the post- chemotherapy than the pre-chemotherapy and were recovered the nearly same but less level at the readmission time. Body fat proportion was increased at the post chemotherapy and then decreased at the readmission phase. Hemoglobin and the number of lymphocyte were below normal at the pre-chemotherapy and more reduced at the readmission time. Anorexia, nausea, and vomiting were related positively and oral intake was negatively related with nausea and vomiting. The nutritional status at the post- chemotherapy and the readmission time was explained 20% over by the side effect like anorexia, nausea, vomiting and oral intake during the chemotherapy. The significant nutrition predictors at the post- chemotherapy were vomiting and the significant predictors at the readmission time were anorexia, vomiting, and oral intake. These results indicated the patients receiving chemotherapy were continued to deteriorate the nutritional status. Therefore nurse should have knowledge how much the nutritional status can be affected and assess the nutritional status periodically and try to find out the intervention for side effects from the series of chemotherapies.

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