Gan to kagaku ryoho. Cancer & chemotherapy
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The primary aim of this study is to clarify the participant-evaluated usefulness of an outreach program by a palliative care team. The palliative care team participated in a community conference and clinical activity in collaboration with a community home care clinic once a month during one year. ⋯ Usefulness for advising symptom control and developing collaborative relationship was high during the study periods, and usefulness for advising psychological care/communication and coordination of location of death gradually increased. In conclusion, an outreach program by a palliative care team could be useful for health care professionals in a community home clinic, and could contribute to better outcomes for cancer patients at home.
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Gan To Kagaku Ryoho · May 2010
Review[How to plan and execute multinational clinical studies properly-management of ethnic differences, private information, and genetic testing].
The need for multinational clinical studies in the oncology field has grown stronger not only for the purpose of registration but also the creation of scientific evidence for proper use of anti-cancer agents. Now almost all clinical study has been planned and executed under international collaboration, including Japan. Multinational study has several advantages to enhance faster accrual from more sites for patients with common malignancies and even with rare tumors, to provide scientific data for the approvals of participating countries, and to deliver meaningful information to medical sites in a broader range at reasonable cost. ⋯ From the study management viewpoint, the regulations in each region may differ to some extent, although efforts of harmonization has been initiated. Therefore, at the study planning stage, the ethnic or regional differences and those in regulations should be taken into consideration in the preparation of study protocol, and several measures should be prepared and implemented for the smooth conduction of the study. It is also recommended that Japan be involved in the development activity at an earlier phase, so that appropriate alternatives, including Asian collaborative studies, could be considered when needed.
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Gan To Kagaku Ryoho · May 2010
[Fever profile of febrile neutropenia in patients treated with cancer chemotherapy for hematological malignancies].
It is important to diagnose infectious events in cancer patients during chemotherapy. Since many of them have complications of febrile neutropenia (FN), determining its cause is critical for their treatment course. We analyzed all febrile events (>38.0 degrees C, single axillary temperature) in hospitalized cancer patients treated at Shizuoka Cancer Center over a period of 8 months. ⋯ In eleven of 18 infection-proven cases, we successfully predicted the infection focus at the onset of fever. Multivariate analysis revealed that initial high fever, antimicrobial prophylaxis, cutaneous findings and severe neutropenia were important influencing factors in predicting infectious disease during FN. Physical examination can support the diagnosis of the cause of fever in FN patients.