Gan to kagaku ryoho. Cancer & chemotherapy
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In Japan, a pain relief for terminally ill cancer patients has been improved greatly in the past twenty years owing to the appearance of several new opioids and manuals available, loosening the usage of opioids legally, and so on. Medical institutions including clinics which are involved in home palliative care have the knowledge and techniques in certain levels. ⋯ Though very few, certain clinics can do the continuous subarachnoid morphine injection using subcutaneous indwelling port. Considering that home palliative care including pain control required a professional knowledge and techniques, it is necessary to establish a new system in the district which enables to provide the palliative care of high quality by a team in which palliative care clinic or PCC exists as the main medical center.
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Gan To Kagaku Ryoho · Dec 2009
Comparative Study[Cost-effective analysis of rotation from sustained-release morphine tablet to transdermal fentanyl of matrix type or sustained-release oxycodone tablet].
The present study was undertaken to determine the pharmacoeconomics of switching from sustained-release morphine tablet to matrix type (MT) of transdermal fontanel or sustained-release Oxycodone tablet. Cost-effective analysis was performed using a simulation model along with decision analysis. ⋯ The cost-effective ratio/patient of transdermal MT fontanel (22, 539 yen)was lower than that of sustained -release Oxycodone tablet (23, 630 yen), although a sensitivity analysis could not indicate that this result was reliable. These results suggest the possibility that transdermal MT fontanel was much less expensive than a sustained-release Oxycodone tablet.
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Gan To Kagaku Ryoho · Dec 2009
Clinical Trial[New response evaluation criteria in solid tumours-revised RECIST guideline (version 1.1)].
This paper is an overview of the new response evaluation criteria in solid tumours: revised RECIST guideline (version 1. 1), with a focus on updated contents.
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Gan To Kagaku Ryoho · Dec 2009
[The university hospital palliative care team's approach to the transfer of end-stage cancer patients from hospital care to home medical care].
The palliative care team's roles are to provide a symptom relief to cancer patients, help them accept their medical conditions, and offer advice regarding the selection of appropriate medical treatments to suit their needs. Seeking the comfort of their homes, patients prefer a home care of superior medical care provided at hospitals. ⋯ To treat the end-stage cancer patients at home, there is a need for information sharing and a joint training of physicians specialized in cancer therapy, palliative care teams, home physicians, and visiting nurses. This would ensure a sustainable "face-to-face collaboration" in community health care.
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Gan To Kagaku Ryoho · Dec 2009
[End of life care in children with cancer and problems--pediatric palliative care at hospital and home].
We cared 28 life limiting children with cancer in the past five years. Two patients died at home and the rest of them died at hospitals. Most children older than 11 years understood their disease. ⋯ There were some problems associated with going back home. Those were as follows: a decision making was difficult for the patients because some of them were very young or unconcious not awake, not enough time for the patient's family to get ready for a home palliative care, or the patients who need frequent transfusions. In palliative care of children with the end of life stage cancer, it is essential that more co-medicals and other professions should be involved in order to strive for a good quality of life.