卵巣癌carboplatin/paclitaxel療法に対する科学的根拠に基づいたクリニカル・パスの作成

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Recently, carboplatin/paclitaxel (TJ) therapy has been recommended as a standard treatment for ovarian cancer. However, a clinical pathway for the safe use of these novel anticancer agents had not been established. We prepared a clinical pathway based on evidence-based medicine (EBM) using information from clinical records and the literature. We analyzed the clinical records of 33 patients who had undergone TJ therapy for ovarian cancer and were hospitalized in the gynecology ward of the Showa University Hospital. Grade 3 or higher toxicities of leucopenia, neutropenia, and thrombocytopenia occurred in 52%, 55%, and 6% of these patients, respectively. There were also high incidences of nausea, vomiting, arthralgia, and peripheral neuropathy. Check lists for these toxicities were therefore included in the clinical pathway. The National Cancer Institute Common Toxicity Criteria (NCI-CTC) were used for evaluation of the toxicities. Medicines and medication criteria for supportive treatment were described based on the guidelines of the American Society of Clinical Oncology (ASCO) or the U.S. Infection Society. Doctors and co-medicals, nurses and pharmacists participated in discussions aimed at making the clinical pathway safe, easy to use and readily available to wards. Firmly based on EBM and including guidelines for conducting chemotherapy safely, the clinical pathway that we prepared should be helpful in risk management.
日本医療薬学会の論文
2004-06-10

卵巣癌carboplatin/paclitaxel療法に対する科学的根拠に基づいたクリニカル・パスの作成

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