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As a preventive measure for occupational exposure to anticancer drugs, the use of a closed system drug transfer device (CSTD)is not widespread. The main reason for this is the high cost of the equipment. For inpatient chemotherapy(Ⅳ)at our hospital, CSTD was used for the following 3 drugs, cyclophosphamide, ifosfamide, and bendamustine; however, from Nov. 2018, CSTD was used for all chemotherapy drugs. Meanwhile, the personal protective equipment (PPE) for ward nurses was simplified. The purpose of this study was to determine the effects of increased CSTD use and simplification of PPE on the cost of medical materials. Information collected between Apr. and Sep. 2019 was extracted from health records. The total number of inpatient chemotherapy treatments during the study period was 970. The increase in the cost of drug administration equipment due to expansion of CSTD use was ¥1.74 million per half a year. However, the cost savings from simplifying PPE was approximately ¥290,000 per half a year, which is about 16.8% of the increase in cost. We hope that the amount of reimbursement will increase and that device prices will decrease as CSTD use becomes more widespread.

Patients with gastrointestinal cancer who were receiving moderately emetogenic chemotherapy (MEC) were switched from granisetron, a first-generation 5-hydroxytryptamine-3 receptor antagonist, to palonosetron at our hospital. In the present study, we compared effectiveness before and after switching antiemetic treatment. Among patients who were receiving MEC for gastrointestinal cancer, we prospectively observed 46 patients given granisetron and 46 given palonosetron. To allow adverse reactions to be graded in accordance with the Common Terminology Criteria for Adverse Events, version 4.0, a questionnaire designed at our hospital was used to compare the occurrence of delayed nausea and vomiting between patients who received granisetron (GRA group) and those who received palonosetron (PAL group). The incidence of delayed nausea was significantly lower in the PAL group (8.7 %, 4/46; p

Drug cost is considered an important factor in treatment compliance for cancer patients. However, it is difficult to calculate individual drug costs. We were previously unable to provide sufficient information on costs to cancer patients starting drug therapy. Therefore, we developed a tool, in the form of a spreadsheet, which calculates drug costs for breast cancer treatment. This software tool runs on every terminal for electronic medical charts in our hospital. To evaluate the tool, we created 10 fictional breast cancer patient sets. Five pharmacists calculated the drug costs for a single regimen using method A (without software) and method B (with software). The pharmacists then calculated the drug costs for 3 regimens in the same way. We compared the time taken to calculate costs using method A and method B. For the single regimen, the mean time for method B (22.6±6.9 s) was 6.4-times shorter than that for method A (145.2±28.3 s, p0.0001). For the 3 regimens, the mean time for method B (35.5±5.0 s) was 8.9-times shorter than that for method A (315.8±43.1 s, p0.0001). The differences observed were statistically significant. By using the software, we were able to shorten the calculation time for drug costs, and therefore, alleviate the burden on medical staff.

Thirteen months following surgery, local recurrence and multiple lung metastases occurred. Hormone therapy was continued following the recurrence but was found to be ineffective, so the patient was referred to our hospital 9 months after the recurrence. Capecitabine-based chemotherapy was administered but found to be ineffective; 3 months later, the anti-cancer drug was changed to S-1. After 3 months of S-1 administration, a CT scan showed a marked reduction in sites of recurrence and metastasis, making it possible to control progression of the disease over a longer period. No critical adverse reactions were observed, suggesting that S-1 can be useful and safe for the treatment of capecitabine-resistant recurrent breast cancer.

We encountered a 64-year-old UGT1A1*28 heterotype patient who received CPT-11 and CDDP chemotherapy for Stage III A small-cell lung-cancer and developed grade 4 neutropenia as assessed by CTCAE v3.0 in Pharmaceutical Management. The therapeutic effect was good; 4 courses of chemotherapy could be safely administered at 1/3 of the applied dose of CPT-11, and CR was obtained. In this period, we participated in selecting antibiotics to neutropenia and CPT-11 closing regimen as pharmacists. Additionally, we carefully monitored patients about their bowel pattern and hematotoxicity, and collected information about gene searching for the patient and the Hospital Ethics Committee. The analysis of the gene polymorphism of CPT-11 is useful to predict the occurrence of serious side effects, but this judgment cannot easily be made clinically. In the event of a marked decrease in the neutrophil count of a patient during the first courses of treatment with CPT-11, we believe that it is important to consider gene polymorphism, to closely monitor the symptoms and laboratory parameters, and to give a smaller dose of the drug.

A 79-year-old man was referred to our hospital with urinary retention in August 2004. Because the serum PSA was 2,9 39 ng/mL,we performed transabdominal prostatic needle biopsy. Pathological examination of the prostate revealed conventional adenocarcinoma. CT scans and MRI showed a huge mass and lymph node metastasis. He was treated with diethyl stilbestrol diphosphate,followed by maximal androgen blockade therapy,and the serum PSA level decreased favorably. Follow-up CT revealed prostate and lymph node metastasis were reduced, but liver metastases, measuring 45 x 34 mm and 28 x 24 mm, respectively, were newly recognized in February 2006. The NSE level was high at 88.5 ng/mL, so a percutaneous liver biopsy was performed,and pathological examination of the liver revealed metastatic prostate cancer which showed neuroendocrine differentiation. The treatment was changed to chemotherapy comprising cisplatin and irinotecan. After three courses of the chemotherapy,liver metastasis was reduced in CT scans.

e17797 Background: Drug cost is considered an important factor in the continuation of treatment for cancer patients. However, it is difficult to calculate individual drug cost. We were not able to ...