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Title: 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
Other Titles: Effectiveness of Cooperative Treatment Using Community Medical Systems and Healthcare Services for Second-Line Therapy in Advanced Urothelial Cancer Patients : Impact on Survival
Authors: 宮田, 康好  KAKEN_name
松尾, 朋博  KAKEN_name
光成, 健輔  KAKEN_name
大庭, 康司郎  KAKEN_name
酒井, 英樹  KAKEN_name
Author's alias: Miyata, Yasuyoshi
Matsuo, Tomohiro
Mitsunari, Kensuke
Ohba, Kojiro
Sakai, Hideki
Keywords: Urothelial cancer
Cooperative medical system
Quality of life
Issue Date: 30-Apr-2020
Publisher: 泌尿器科紀要刊行会
Journal title: 泌尿器科紀要
Volume: 66
Issue: 4
Start page: 107
End page: 113
Abstract: 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.
Rights: 許諾条件により本文は2021/05/01に公開
DOI: 10.14989/ActaUrolJap_66_4_107
PubMed ID: 32483944
Appears in Collections:Vol.66 No.4

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