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タイトル: | 進行性尿路がんの2次治療における地域の医療・福祉サービスとの診療連携の有用性 : 生命予後やQoLへの影響 |
その他のタイトル: | Effectiveness of Cooperative Treatment Using Community Medical Systems and Healthcare Services for Second-Line Therapy in Advanced Urothelial Cancer Patients : Impact on Survival |
著者: | 宮田, 康好 松尾, 朋博 光成, 健輔 大庭, 康司郎 酒井, 英樹 |
著者名の別形: | Miyata, Yasuyoshi Matsuo, Tomohiro Mitsunari, Kensuke Ohba, Kojiro Sakai, Hideki |
キーワード: | Urothelial cancer Cooperative medical system Survival Quality of life |
発行日: | 30-Apr-2020 |
出版者: | 泌尿器科紀要刊行会 |
誌名: | 泌尿器科紀要 |
巻: | 66 |
号: | 4 |
開始ページ: | 107 |
終了ページ: | 113 |
抄録: | Chemotherapy and immune-checkpoint inhibitors, used as second-line treatments for advanced urothelial cancer (UC), can have adverse effects in some patients, such as decreased organ function. We investigated the effectiveness of cooperation with medical/welfare services, so-called cooperative medicine, in these cases. A total of 137 UC patients who had undergone second-line therapy were analyzed. Of these 137 patients, 49 were categorized in the "cooperative"treatment group, in which a general practitioner performed blood tests and transfusions ; and, administered medication, while nurses and case workers from a community health care institution provided mental and social support. There were 50 in the "joint" treatment group, who were treated jointly by a urologist and general practitioner ; and, 38 in the "solo" treatment group who were treated by a urologist only. The Short Form Health Survey, SF-36, was used to evaluate quality of life (QoL). We observed that the overall survival after the second-line treatment was significantly longer in the cooperative group than in the other two groups, with multivariate analyses confirming cooperative treatment as a significant factor for better prognosis (P=0.005). The period of second-line treatment in the cooperative group was significantly longer (P=0.003) than that in the solo group, whereas the proportion of patients who subsequently received third-line treatment was higher in the cooperative group, 58. 5%, than in the solo and joint groups, 26. 5% and 25. 5%, respectively. Posttreatment QoL measurements in the joint and solo groups were significantly lower for 3 and 6 items, respectively, whereas there was no appreciable decrease in post-treatment QoL measurements in the cooperative group. Multivariate analysis showed that cooperative treatment was particularly beneficial for female patients ≥75 years of age, and patients with status 2 performance. |
著作権等: | 許諾条件により本文は2021/05/01に公開 |
DOI: | 10.14989/ActaUrolJap_66_4_107 |
URI: | http://hdl.handle.net/2433/251050 |
PubMed ID: | 32483944 |
出現コレクション: | Vol.66 No.4 |
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