title: Attitudes and practice patterns for maintaining relative dose intensity of chemotherapy in outpatient clinics: results of a Japanese web-based survey.
abstract: BACKGROUND
  This analysis was undertaken to evaluate the practice patterns of Japanese physicians regarding curative-intent chemotherapy, especially in outpatient settings, and to define factors negatively affecting the maintenance of relative dose intensity (RDI).
  
  
  METHODS
  We performed a web-based questionnaire survey of Japanese physicians involved in malignant lymphoma chemotherapy (Group ML) or in breast cancer chemotherapy (Group BC). The questionnaire inquired how they manage low-risk febrile neutropenia (FN) caused by initial chemotherapy for diffuse large B-cell lymphoma(DLBCL) or by adjuvant chemotherapy for breast cancer in an outpatient setting.
  
  
  RESULTS
  Valid responses were obtained from 185 physicians in Group ML and 160 in Group BC. In Group ML, 76 % (n = 141) of the physicians were board-certified hematologists, while 82 % (n = 131) of the physicians in Group BC were board-certified surgeons. A significantly higher proportion of physicians in Group ML responded that "dose reduction is not required for the subsequent course of chemotherapy after the first episode of FN" than in Group BC (ML versus BC; 77 % versus 31 %; P < 0.001). Significantly higher proportions of physicians in Group ML were more likely to prophylactically administer antibiotics or granulocyte-colony stimulating factor (G-CSF; ML versus BC; antibiotics: 36 % versus 26 %, P = 0.049; G-CSF: 25 % versus 16 %, P = 0.047). Eighty six percent (n = 159) of Group ML and 70 % (n = 112) of Group BC responded that "emergency outpatient unit is open at all hours".
  
  
  CONCLUSIONS
  Japanese physicians are more likely to administer reduced doses of chemotherapy to patients with breast cancer than to patients with malignant lymphoma. Supportive infrastructures should be improved to ensure the provision of adequate chemotherapy to all cancer patients.
authors.affiliation: Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, 1-396, Kosugi-machi, Nakahara-ku, Kawasaki City, Kanagawa, 211-0063, Japan. hitomisakai@nms.ac.jp.
authors.forename: Hitomi
authors.initials: H
authors.lastname: Sakai
authors.affiliation: Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, 1-396, Kosugi-machi, Nakahara-ku, Kawasaki City, Kanagawa, 211-0063, Japan. nkatsuma@nms.ac.jp.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Katsumata
authors.affiliation: Department of Medical Oncology, Nippon Medical School Musashikosugi Hospital, 1-396, Kosugi-machi, Nakahara-ku, Kawasaki City, Kanagawa, 211-0063, Japan. genmu-gk@nms.ac.jp.
authors.forename: Genmu
authors.initials: G
authors.lastname: Kadokura
mesh_terms: D000328:Adult; D000368:Aged; D000554:Ambulatory Care Facilities; D000970:Antineoplastic Agents / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D001291:Attitude of Health Personnel; D019468:Disease Management; D064147:Febrile Neutropenia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D020407:Internet; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology*; D010818:Practice Patterns, Physicians'; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents