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Outpatient chemotherapy and clinical pathway for non-small cell lung cancer]
Authors:Kiyoshi Komuta  Seiichi Nobuyama  Kouta Iwahori  Chika Mukouchi  Keisuke Koga  Junpei Kondo  Mitsuko Asai  Seigo Minami
Institution:Department of Respiratory Medicine, Osaka Police Hospital, 10-31 Kitayama-cho, Tennoji-ku, Osaka City, 543-0035 Osaka, Japan.
Abstract:We investigated the usefulness of outpatient chemotherapy in 54 cases of non-small cell lung cancer in which outpatient chemotherapy was performed between August 1999 and October 2001. This chemotherapy accounted for 67% of all chemotherapy. Assessment of therapeutic effect revealed a PR in 14 of the 54 cases, and the efficacy rate was 26%. Therapeutic effect according to chemotherapy regimen revealed the highest efficacy rate, 50%, for paclitaxel + CBDCA. The median survival time was 14.7 months, and the 1-year survival rate was 61.1%. On the basis of the above results, a 16-day inpatient clinical pathway using weekly paclitaxel + CBDCA was devised for non-small cell lung cancer. The aim was to shorten the number of inpatient days, standardize treatment, and introduce outpatient chemotherapy. The clinical pathway was introduced in 8 patients with recurrent non-small cell lung cancer between August and October 2002. Variance was found only in one patient whose hospital discharge had to be postponed by two days because of a Grade 3 side effect. Introduction of a clinical pathway with weekly paclitaxel + CBDCA successfully reduced the inpatient days to an average of 16.3 days.
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