scholarly journals Effectiveness of protocol-based pharmacotherapy management collaboration between hospital and community pharmacists to address capecitabine-related hand–foot syndrome in cancer patients: a retrospective study

Author(s):  
Nobuhiko Nakamura ◽  
Hiroki Shiraiwa ◽  
Yasuhiro Haruna ◽  
Tomoki Ichijima ◽  
Tomoko Takeda ◽  
...  

Abstract Background Pharmaceutical care of capecitabine-related hand–foot syndrome (HFS) is extremely important to avoid the progression of the syndrome. Protocol-based pharmacotherapy management (PBPM) of HFS by community pharmacists has been introduced in our community, whereby the community pharmacist instructs patients to use steroid creams if they develop HFS of grade 2 or higher. This study aimed to evaluate the effectiveness of PBPM in cancer patients with HFS by comparing it to conventional pharmaceutical care using monitoring reports for pharmacotherapy management by community pharmacists. Methods From September 2017 to August 2019, we retrospectively investigated the medical records of 396 cancer patients who received capecitabine adjuvant chemotherapy. Before PBPM implementation, conventional pharmaceutical care was administered from September 2017 to August 2018; these patients served as the control group. Care was switched to PBPM in September 2018, and PBPM was applied from September 2018 to August 2019; these patients served as the PBPM group. We excluded patients who received both conventional pharmaceutical care and PBPM. We categorized all cases into two groups: age ≤ 69 years and age ≥ 70 years. Results In all, 396 cases were included, of which 227 were ineligible, such as those of cancer patients who received both conventional pharmaceutical care and PBPM. Among patients aged higher than 70 years, the incidence and severity of HFS associated with PBPM were significantly lower than those associated with conventional care (grade 0: 59.5% [44/74] vs. 30.6% [11/36], grade 1: 33.8% [25/74] vs. 63.9% [23/36]). All patients continued to receive the capecitabine, HFS severity improved to grade 1 during the study period, and treatment of HFS was not stopped. Conclusion Our findings suggest that PBPM is effective for addressing capecitabine-related HFS among cancer patients aged higher than 70 years, in that it helps prevent an increase in HFS severity.

Care Weekly ◽  
2021 ◽  
pp. 1-5
Author(s):  
Li Hongyan ◽  
Lu Wanting ◽  
Li Fei

Palliative chemotherapy prolongs survival and improves quality of life. However, a variety of chemotherapeutics including oxaliplatin can cause severe side effects during treatments, leading to painful symptoms that might result in the interruption of cancer treatment. Although adding oxaliplatin to fluorouracil and leucovorin in adjuvant chemotherapy for colon and rectal cancer may improve disease-free survival, it also increases grade 3–4 sensory neuropathy. Our study aimed to determine whether oral Mecobalamin is neuroprotective against oxaliplatin-induced neuropathy. Forty-six stage III colon and rectal cancer patients receiving adjuvant biweekly oxaliplatin were randomized to oral Mecobalamin (1,500 mg; case group) or placebo (control group). Clinical neurological and electrophysiological evaluations were performed at baseline and after 4, 8, and 12 treatment cycles. Treatment-related toxicity was evaluated based on National Cancer Institute (NCI) criteria. After four cycles of chemotherapy, 9 of 23 patients in the control group and 8 of 23 patients in case group experienced grade 1 sensory neuropathy. After eight cycles, 13 patients experienced sensory neuropathy (grade 2–4 toxicity) in the control group; however, no patients in the case group experienced sensory neuropathy (P < 0.05). After 12 cycles, grade 2–4 sensory neuropathy was observed in 20 patients in the control group, but only in 4 patients in the case group (P < 0.05). We did not observe any significant electrophysiological changes in the case group after 4, 8, or 12 cycles of chemotherapy. Thus, we demonstrated that oral Mecobalamin reduces the incidence of neuropathy in colon and rectal cancer patients receiving oxaliplatin-based adjuvant chemotherapy.


2021 ◽  
Author(s):  
Shang-Yih Chan ◽  
Yun-Ju Lai ◽  
Yu-Yen Hsin Chen ◽  
Shuo-Ju Chiang ◽  
Yi-Fan Tsai ◽  
...  

Abstract Purpose Studies to examine the impact of end-of-life (EOL) discussions on the utilization of life-sustaining treatments near death were limited and had inconsistent findings. This nationwide population-based cohort study determined the impact of EOL discussions on the utilization of life-sustaining treatments in the last three months of life in Taiwanese cancer patients. Methods This cohort study included adult cancer patients from 2012–2018, which were confirmed by pathohistological reports. Life-sustaining treatments during the last three months of life included cardiopulmonary resuscitation, intubation, and defibrillation. EOL discussions in cancer patients were confirmed by their medical records. Association of EOL discussions with utilization of life-sustaining treatments were assessed using multiple logistic regression. Results Of 381,207 patients, the mean age was 70.5 years and 19.4% of the subjects utilized life-sustaining treatments during the last three months of life. After adjusting for other covariates, those who underwent EOL discussions were less likely to receive life-sustaining treatments during the last three months of life compared to those who did not (Adjusted odds ratio [AOR]: 0.82; 95% confidence interval [CI]: 0.80–0.84). Considering the type of treatments, EOL discussions correlated with a lower likelihood of receiving cardiopulmonary resuscitation (AOR = 0.43, 95% CI: 0.41–0.45), endotracheal intubation (AOR = 0.87, 95%CI: 0.85–0.89), and defibrillation (AOR = 0.52, 95%CI: 0.48–0.57). Conclusion EOL discussions correlated with a lower utilization of life-sustaining treatments during the last three months of life among cancer patients. Our study supports the importance of providing these discussions to cancer patients to better align care with preferences during the EOL treatment.


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Wenjun Meng ◽  
Xiaoge Zeng ◽  
Yuchen Gao ◽  
Qi Chen ◽  
Lian Bai

Background. Adjuvant chemotherapy with CapeOX regimen is widely used in resected rectal cancer, which brings benefits to patients. But drug-related toxicities are severe during this process; thus, survival outcomes may potentially be affected. This study explored the efficacy of two Chinese herbal injections, Aidi injection (ADI) and Brucea javanica oil emulsion injection (BJOEI), as adjuvant drugs in CapeOX adjuvant chemotherapy on rectal cancer patients. Methods. A total of 240 cases were enrolled in this retrospective study. 80 cases received CapeOX with ADI (the ADI group), 80 cases received CapeOX with BJOEI (the BJOEI group), and the rest 80 cases received CapeOX alone (the control group). After four cycles’ chemotherapy, adverse reactions (ADRs) and quality of life (QOL) were analyzed. Then, patients received follow-up for at least one year, and the endpoint was disease-free survival (DFS). Results. All patients completed at least four cycles’ adjuvant chemotherapy. The incidence of leukopenia and thrombocytopenia was significantly lower in the ADI group; the incidence of nausea was significantly lower in the BJOEI group; the incidence of hand-foot syndrome was significantly lower in both the ADI group and BJOEI group. Significant difference was found in the control group regarding the Karnofsky Performance Status (KPS) scores prior and posttreatment. No difference was found among three groups regarding one-year DFS. Conclusion. As adjuvant drugs for rectal cancer during CapeOX chemotherapy, ADI shows advantages in decreasing leukopenia and thrombocytopenia, while BJOEI results better in remitting nausea. Both two CHIs had positive impacts on decreasing hand-foot syndrome and the maintenance of patients’ QOL. It is worthy of further study and promotion for CHIs.


2021 ◽  
Vol 42 (3) ◽  
pp. 340-350
Author(s):  
Eun-ji Kim ◽  
Chan-ran Park ◽  
Chang-gue Son ◽  
Jung-hyo Cho ◽  
Nam-hun Lee

Objectives: Hand-foot syndrome (HFS) is a common adverse effect of chemotherapy in cancer patients. This review synthesizes research results to assess the effect of traditional Korean medicine (TKM) on HFS in cancer patients.Methods: Four databases (PubMed, The Cochrane Central Register of Controlled Trials, Research Information Sharing Service, China National Knowledge Infrastructure) were searched for randomized controlled trials (RCTs) to assess the effects of TKM on HFS. The effects and quality of RCTs were assessed with the Cochrane risk of bias (ROB) tool.Results: Six RCTs met our study criteria. In all six, TKM showed improvement in HFS symptoms as well as quality of life scores when compared to the control group. However, the methodological quality of RCTs was relatively low due to the unclear or high ROB.Conclusions: TKM would be helpful to patients with HFS after chemotherapy. To clarify the clinical efficacy of TKM, well-designed studies are required in the future.


2021 ◽  
Vol 104 (6) ◽  
pp. 887-894

Background: Cluster symptoms are a common occurrence in breast cancer patients undergoing chemotherapy. The telephone is a well-recognized, convenient device for reaching out to patients for monitoring and managing their symptoms in an efficient, prompt, and appropriate manner. Objective: To investigate the efficacy of telephone-based intervention to achieve energy conservation among breast cancer patients with the aim of alleviating fatigue, pain, sleep disturbance, and depression. Materials and Methods: The present study was a two-armed, randomized control trial conducted in the university hospital between March and September 2019. Seventy-four breast cancer patients, receiving four courses of adjuvant chemotherapy, were randomly recruited and assigned into the experimental group and the control group. One face-to-face intervention interview for energy conservation was conducted, followed by 20-minutes telephone brief counselling and assessment sessions, scheduled on day 1, 2, 7, and 14. Results: The scores for symptoms of median fatigue and pain in the experimental group were shown to be significantly reduced at the end of the study as compared to those scores within the control group (p<0.05). Similarly, scores for median sleep time and depression were greater at the end of cycle 1 and highest in cycle 2 (p<0.05, 0.001, respectively). Physical activity levels were also higher in the experimental group than in the control group in every cycle, with a statistical significance (p<0.001). Conclusion: The present study intervention demonstrated an effectiveness for the reduction of cluster symptoms. Further studies would be needed in a larger population scale in the customary, randomized controlled trial manner. Keywords: Cancer; Energy conservation; Fatigue; Pain; Sleep; Telephone


2019 ◽  
Vol Volume 11 ◽  
pp. 129-144 ◽  
Author(s):  
Berna Demiralp ◽  
Lane Koenig ◽  
Jaya Kala ◽  
Chaoling Feng ◽  
Elizabeth G. Hamlett ◽  
...  

Author(s):  
V.E. Voitsitsky ◽  
◽  
V.A. Lebedeva ◽  
O.A. Tkachuk ◽  
I.V. Skuridina ◽  
...  

The incidence of oncological pathology in Russia and throughout the world is steadily growing, and the mortality rate is not decreasing either. A large number of locally advanced and neglected cases of cancer of various location are revealed. Treatment of these forms requires polychemotherapy (PCT). The study included 52 patients with oncological pathology of various location: head and neck, stomach, large intestine, they underwent adjuvant chemotherapy according to the PF, TPF and FOLFOX regimens, which include an infusion of 5-fluorouracil for 2–5 days. The study analyzed gastrointestinal toxicity according to CTCAE, version 4.03, 2010. It was revealed that the addition of the probiotic Biovestin to meal reduces gastrointestinal toxicity by 2 times compared with the control group and reduces the risk of interruption of the PCT course by 19 % due to the development of side effects. Thus, the addition of the probiotic Biovestin has shown its effectiveness, safety and simplicity of use in the prevention of gastrointestinal disorders in cancer patients under conditions of PCT.


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