title: [Clinical pathway based on evidence-based medicine (EBM) for chemotherapy for lung cancer].
abstract: Recently, combination treatment with cisplatin has been recommended as chemotherapy for lung cancer. However, no clinical pathway for safe and efficient use of anticancer agents has been established. We devised a clinical pathway satisfying evidence-based medicine (EBM) criteria by analyzing case records and the relevant literature. We analyzed 73 case records of hospitalized patients who had undergone chemotherapy for lung cancer on the internal medicine ward of the Showa University Hospital. Grade 3 or higher toxicities of leukopenia, thrombocytopenia, anemia, vomiting, and diarrhea occurred in 30%, 51%, 14%, 5%, 8%, and 1% of patients, respectively. Therefore the checklists for these toxicities were included in the clinical pathway. The National Cancer Institute Common Toxicity Criteria were used for the evaluation of toxicities. According to the guidelines of the American Society of Clinical Oncology and the US Infection Society, the indicated agents and criteria for their use were chosen for supportive cancer treatment. Pharmacists, physicians, and nurses collaborated in making the clinical pathway safe and sufficiently easy for practical use. The final version of the clinical pathway is compatible with EBM and includes items required for safe chemotherapy, which could be helpful in risk management.
authors.affiliation: Department of Pathophysiology, School of Pharmaceutical Sciences, Showa University, Tokyo 142-8555, Japan.
authors.forename: Mari
authors.initials: M
authors.lastname: Kogo
authors.forename: Yumi
authors.initials: Y
authors.lastname: Saito
authors.forename: Yuka
authors.initials: Y
authors.lastname: Kashiwabara
authors.forename: Kayoko
authors.initials: K
authors.lastname: Koichi
authors.forename: Ikue
authors.initials: I
authors.lastname: Ichikawa
authors.forename: Naoya
authors.initials: N
authors.lastname: Horichi
authors.forename: Toshimichi
authors.initials: T
authors.lastname: Imai
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Adachi
authors.forename: Jun-Ichiro
authors.initials: J
authors.lastname: Murayama
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kiuchi
mesh_terms: D058186:Acute Kidney Injury / Q000139:chemically induced / Q000517:prevention & control; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D002166:Camptothecin / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives*; D016190:Carboplatin / Q000008:administration & dosage; D002289:Carcinoma, Non-Small-Cell Lung / Q000188:drug therapy*; D018288:Carcinoma, Small Cell / Q000188:drug therapy*; D002945:Cisplatin / Q000008:administration & dosage / Q000009:adverse effects; D019091:Critical Pathways; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D000077146:Irinotecan; D007970:Leukopenia / Q000139:chemically induced / Q000517:prevention & control; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D014839:Vomiting / Q000139:chemically induced / Q000517:prevention & control
chemical_list: D005047:Etoposide; D000077146:Irinotecan; D016190:Carboplatin; D002945:Cisplatin; D002166:Camptothecin