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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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Clinical Safety and Efficacy of Kanglaite® (Coix Seed Oil) 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;Xiang, Jin;Ye, Li-Hong
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.5319-5321
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    • 2012
  • Objective: To observe efficacy and side effects, as well as the impact on quality of life, of Kanglaite$^{(R)}$ (Coix Seed Oil) injections combined with chemotherapy in the treatment of advanced gastric cancer patients. Method: A consecutive cohort of 60 patients were divided into two groups: the experimental group receiving Kanglaite$^{(R)}$ Injection combined with chemotherapy and the control group with chemotherapy alone. After more than two courses of treatment, efficacy, quality of life and side effects were evaluated. Results: The response rate and KPS score of experimental group were significantly improved as compared with those of the control group (P<0.05). In addition, gastrointestinal reactions and bone marrow suppression were significantly lower than in the control group (P<0.05). Conclusions: Kanglaite$^{(R)}$ Injection enhanced efficacy and reduced the side effects of chemotherapy, improving quality of life of gastric cancer patients; use of Kanglaite$^{(R)}$ injections deserves to be further investigated in randomized control clinical trails.

Clinical Research on Albumin-Bound Paclitaxel-Based Chemotherapy for Advanced Esophageal Cancer

  • Yuan, Yuan;Zhang, Yan;Shi, Lin;Mei, Jing-Feng;Feng, Jif-Eng;Shen, Bo
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.4993-4996
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    • 2015
  • Background: To evaluate the efficacy and safety of albumin-bound paclitaxel-based chemotherapy in treatment for patients with advanced esophageal cancer who failed in first-line chemotherapy. Materials and Methods: We collected29 advanced esophageal cancer patients who received albumin-bound paclitaxel-based chemotherapy fromJune 2009 to September 2013, and the efficacy and safety of the compound were evaluated. These patients were treated with $100-150mg/m^2$ nab-paclitaxel on days 1,8. The cycle was repeated every 3 weeks. Clinical efficacy was evaluated every two cycles. Results: Of the 29 patients, two persons interrupted treatment because of adverse reactions, failed to evaluate efficacy effect. The rest of 27 patients who could be evaluated for short-term response, 10 patients (37%) achieved partial response, 2 (7.4%) remained stable disease, and 15 (55.6%) had progressivedisease. The objective response rate was 37%, and the disease control rate was 44.4%.The median time to progression was 6.6 months.The major adverse reactions includedalopecia (62.07%), neutropenia (65.5%), gastrointestinalreaction (10.3%) andsensory neuropathy(6.8%). Conclusions: The albumin-bound paclitaxel-based chemotherapy is efficacy and safety in treatment for patients with advanced esophageal cancer who failed in first-line chemotherapy.

Effect of Portal Vein Chemotherapy on Liver Metastasis after Surgical Resection of Colorectal Cancer

  • Yu, Dong-Sheng;Li, Ying;Huang, Xin-En;Lu, Yan-Yan;Wu, Xue-Yan;Liu, Jin;Cao, Jie;Xu, Xia;Xiang, Jin;Wang, Guo-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.9
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    • pp.4699-4701
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    • 2012
  • Objective: To explore the effect of portal vein chemotherapy on liver metastasis after surgical resection of colorectal cancer. Methods: Patients fulfilling the eligibility criteria were assigned to receive either surgery plus 1-week continuous infusion of 5-FU (study group) or surgery alone (observational group). Patients in the study group received portal vein chemotherapy, whereby 5-FU (1000 mg/d) and heparin (5000 IU/d) infusion was initiated from the day of surgery and lasted for 7 consecutive days. Liver metastasis was monitored during five years follow-up postoperatively. Results: Sixty four patients were recruited and assigned to the study group (12 with colon and 20 with rectal cancer) or the control group (10 with colon and 22 with rectal cancer). Liver metastasis rate was 12.5% in study and 25.0% in observational group, the difference being significant (P<0.01). Conclusion: Portal vein chemotherapy could be an effective treatment in preventing liver metastasis after surgical resection of colorectal cancer.

Progress and Challenges in Chemotherapy for Loco-Regionally Advanced Nasopharyngeal Carcinoma

  • Liang, Zhong-Guo;Chen, Ze-Tan;Li, Ling;Qu, Song;Zhu, Xiao-Dong
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.4825-4832
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    • 2015
  • Incidence rates of nasopharyngeal carcinoma are high in Indonesia, Singapore and South-Eastern China. Chemoradiotherapy has been the standard regimen for locally advanced nasopharyngeal carcinoma according to guidelines from the National Comprehensive Cancer Network. Recently, advances in the management of nasopharyngeal carcinoma have transferred into better treatment outcomes. Most phase III clinical trials support the addition of concurrent chemotherapy to radiotherapy for the initial treatment of these patients. Studies evaluating effects and toxicity of concurrent chemotherapy with different regimens have been reported. However, the status of adding adjuvant chemotherapy or induction chemotherapy remains controversial. Recent studies have shown that adjuvant chemotherapy with two or three cycles may improve survival for nasopharyngeal carcinoma with stage N2-3 disease or with persistently detectable plasma EBV DNA after radiotherapy. This review examines the pertinent issues and latest studies concerning the management of loco-regionally advanced NPC, regarding concurrent chemotherapy, adjuvant chemotherapy, and induction chemotherapy in decades.

Clinical Study on Safety of Cantharidin Sodium and Shenmai Injection Combined with Chemotherapy in Treating Patients with Breast Cancer Postoperatively

  • Wang, Lin;Huang, Xin-En;Cao, Jie
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.14
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    • pp.5597-5600
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    • 2014
  • Objectives: To assess side effects on Cantharidin sodium and Shenmai injection combined with chemotherapy in treating patients with breast cancer postoperatively. Method: Patients with breast cancer receiving postoperative chemotherapy were retrospectively collected, and divided into four groups: group A with cantharidin sodium injection combined with chemotherapy; group B with Shenmai injection combined with chemotherapy; group C with both cantharidin sodium and Shenmai injection combined with chemotherapy; while group D (control group) received chemotherapy alone. All patients were administered docetaxel at a dose of $75mg/m^2$ on day 1, epirubicin hydrochloride at a dose of $60mg/m^2$ on day 1, and cyclophosphamide at a dose of $500mg/m^2$ on day 1 for 3 cycles (repeated at 21 day intervals). After ${\geq}$ three courses of treatment, quality of life and side effects were evaluated. Results: There were a total of 78 patients in this study, and the incidence of leukopenia and gastrointestinal reactions in groups A and B were lower than those in the control group and lowest in group C (p<0.05). Conclusions: Thus cantharidin sodium and Shenmai injection combined with chemotherapy reduce side effects and deserve to be further investigated in randomized clinical control trials.

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.

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 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.