内容紹介
Feasibility and Outcome of S-1 Adjuvant Chemotherapy for Patients with Gastric Cancer Treated Based on the Liaison-Clinical Pathway
Summary
We retrospectively examined the feasibility and outcome of S-1 adjuvant chemotherapy for 18 patients with gastric cancer treated based on the liaison-clinical pathway(liaison group), and compared them with those of 26 patients treated before the induction of the liaison-clinical pathway(non-liaison group). The persistent rate of S-1 adjuvant chemotherapy for one year except for recurrence, the relative performance(RP)value of cases who had received S-1 for one year, and Grade 3/4 adverse events in non-liaison group/liaison group, were 88.5/87.5%(p=0.93), 87.0/92.9%(p=0.56), and 26.9/5.6%(p=0.07), respectively. This did not show a significant difference. The rate of patients administered medication for coexistent diseases in our hospital in the non-liaison group/liaison group was 53.8/0%(p=0.0002), which reflected the accomplishment of the transfer of medical care for coexistent disease from a hospital to a clinic on the liaison-clinical pathway. Furthermore, a neighboring clinic could be arranged to accommodate 9(64.3%)of 14 patients living quite far from the hospital in the liaison group. In conclusion, S-1 adjuvant chemotherapy for patients with gastric cancer treated based on the liaison-clinical pathway was feasible, led to the effective practice of sharing between hospital and clinic, and the shorter trip for treatment at a neighboring clinic by patients living far from a hospital.
要旨
地域連携クリニカルパス(連携パス)によるS-1の胃癌術後補助化学療法の認容性とアウトカムを,連携パス導入前と後ろ向きに比較検討した。連携パス導入前の26例(非連携群)/導入後の18例(連携群)の再発例を除いた1年間のS-1の服薬継続率,1年間S-1を内服できた症例のRP値70%以上の割合,Grade 3以上の有害事象発現割合は,それぞれ88.5%(23/26例)/87.5%(14/16例)(p=0.93),87.0%(20/23例)/92.9%(13/14例)(p=0.56),26.9%(7/26例)/5.6%(1/18例)(p=0.07)であり,両群間に差は認めなかった。当院で併存症に対し処方を行った患者割合は,非連携群/連携群において53.8%(14/26例)/0%(0/18例)(p=0.0002)であり,連携群では併存症に対する処方をすべて診療所に移行できていた。さらに,連携群の遠方からの通院患者14例のうち,9例(64.3%)において自宅近隣の診療所との連携が可能であった。結語: 地域連携パスによるS-1補助化学療法は認容性があり,併診性のメリットを活用でき,患者の通院距離の負担軽減にもつながっていた。
目次
Summary
We retrospectively examined the feasibility and outcome of S-1 adjuvant chemotherapy for 18 patients with gastric cancer treated based on the liaison-clinical pathway(liaison group), and compared them with those of 26 patients treated before the induction of the liaison-clinical pathway(non-liaison group). The persistent rate of S-1 adjuvant chemotherapy for one year except for recurrence, the relative performance(RP)value of cases who had received S-1 for one year, and Grade 3/4 adverse events in non-liaison group/liaison group, were 88.5/87.5%(p=0.93), 87.0/92.9%(p=0.56), and 26.9/5.6%(p=0.07), respectively. This did not show a significant difference. The rate of patients administered medication for coexistent diseases in our hospital in the non-liaison group/liaison group was 53.8/0%(p=0.0002), which reflected the accomplishment of the transfer of medical care for coexistent disease from a hospital to a clinic on the liaison-clinical pathway. Furthermore, a neighboring clinic could be arranged to accommodate 9(64.3%)of 14 patients living quite far from the hospital in the liaison group. In conclusion, S-1 adjuvant chemotherapy for patients with gastric cancer treated based on the liaison-clinical pathway was feasible, led to the effective practice of sharing between hospital and clinic, and the shorter trip for treatment at a neighboring clinic by patients living far from a hospital.
要旨
地域連携クリニカルパス(連携パス)によるS-1の胃癌術後補助化学療法の認容性とアウトカムを,連携パス導入前と後ろ向きに比較検討した。連携パス導入前の26例(非連携群)/導入後の18例(連携群)の再発例を除いた1年間のS-1の服薬継続率,1年間S-1を内服できた症例のRP値70%以上の割合,Grade 3以上の有害事象発現割合は,それぞれ88.5%(23/26例)/87.5%(14/16例)(p=0.93),87.0%(20/23例)/92.9%(13/14例)(p=0.56),26.9%(7/26例)/5.6%(1/18例)(p=0.07)であり,両群間に差は認めなかった。当院で併存症に対し処方を行った患者割合は,非連携群/連携群において53.8%(14/26例)/0%(0/18例)(p=0.0002)であり,連携群では併存症に対する処方をすべて診療所に移行できていた。さらに,連携群の遠方からの通院患者14例のうち,9例(64.3%)において自宅近隣の診療所との連携が可能であった。結語: 地域連携パスによるS-1補助化学療法は認容性があり,併診性のメリットを活用でき,患者の通院距離の負担軽減にもつながっていた。