内容紹介
Summary
We conducted a survey of the outpatient pharmacotherapy we administered from April 2016 to March 2019 to understand trends in chemotherapy for respiratory thoracic malignancies, such as lung cancer. Over the 3—year period, 19,408 were treated in the outpatient chemotherapy department. Of these, 1,270(6.5%)had respiratory thoracic malignancies. The total number of patients and the number of patients with thoracic malignancies(%) were 5,815 and 320(5.5%);6,344 and 434(6.8%);and 7,247 and 516(7.1%)in FY2016, FY2017 and FY2018, respectively. This shows that both increased during the study period. Each patient was treated in the chemotherapy department multiple times, and treatment for thoracic malignancies was initiated in 161 patients. The female:male ratio was 27%:73%, and the patients’ median age(range)was 68 years(range:36—84 years). Lung cancer was the most common disease(91%), followed by malignant pleural mesothelioma(5%), thymoma(2%), thymic carcinoma(1%), and synovial sarcoma(1%). The most common histological type of lung cancer was adenocarcinoma(67%), followed by squamous cell carcinoma(17%), small cell carcinoma(7%), and others(9%). Outpatient chemotherapy was introduced as a first—line, second—line, and third—line or later treatment in 46%, 28%, and 22% of cases, respectively. While the number of patients increased, the number of new patients with thoracic malignancies decreased from 58 in FY2016 to 52 in FY2017 and 51 in FY2018. Conversely, the number of visits to the chemotherapy department by each new patient almost doubled from 5.5 in FY2016 to 8.5 in FY2017 and 10.1 in FY2018. The proportion of patients for which immunotherapy was included in the induction treatment regimen increased from 28% and 24% in FY2016 and FY2017, respectively, to 39% in FY2018. The increase in the use of outpatient chemotherapy for respiratory thoracic malignancies was due to the increase in the proportion of patients undergoing immunotherapy and the number of visits to the chemotherapy department per patient. It is important to implement measures to help prolong and increase the use of outpatient pharmacotherapy for respiratory thoracic malignancies by cooperating with surrounding medical institutions and increasing the number of beds available.
要旨
肺癌など呼吸器系胸部悪性疾患についての動向を知るため,2016年4月～2019年3月までの3年間で当院外来薬物療法について調査を行った。3年間の外来化学療法室全利用者は19,408名で,呼吸器系胸部悪性疾患利用者(胸部利用者)は1,270名(6.5%)であった。3年間の推移は全利用者,胸部利用者(%)の順に2016年度5,815件,320件(5.5%),2017年度6,344件,434件(6.8%),2018年度7,247件,516件(7.1%)であり,各利用者数および胸部の全体に対する割合も増加していた。1人の患者が複数回利用しており,新規に利用した胸部患者161名を検討した。利用者は,女性/男性:27%/73%,年齢中央値(範囲):68(36～84)歳,疾患は肺癌が最も多く(91%),次いで悪性胸膜中皮腫(5%)/胸腺腫(2%)/胸腺癌(1%)/滑膜肉腫(1%),肺癌の組織型は腺癌(67%)/扁平上皮癌(17%)/小細胞癌(7%)/その他(9%),外来薬物療法が導入された時期は一次治療(46%)/二次治療(28%),三次治療以降(22%)であった。利用者数が増加する一方で,新規胸部利用者は2016年度58名,2017年度52名,2018年度51名と減少し,新規利用者1人当たりの利用回数はそれぞれ5.5/8.5/10.1回とほぼ2倍に増加していた。導入治療レジメンにおける免疫療法の割合が28/24/39%と増加していた。呼吸器系胸部外来化学療法数の増加は免疫療法の割合が増加し,1人当たりの外来化学療法室利用回数が増加していることがその原因であった。周囲の医療機関との協力や増床などによる外来薬物療法の長期化と増加への対策が必要である。
目次
We conducted a survey of the outpatient pharmacotherapy we administered from April 2016 to March 2019 to understand trends in chemotherapy for respiratory thoracic malignancies, such as lung cancer. Over the 3—year period, 19,408 were treated in the outpatient chemotherapy department. Of these, 1,270(6.5%)had respiratory thoracic malignancies. The total number of patients and the number of patients with thoracic malignancies(%) were 5,815 and 320(5.5%);6,344 and 434(6.8%);and 7,247 and 516(7.1%)in FY2016, FY2017 and FY2018, respectively. This shows that both increased during the study period. Each patient was treated in the chemotherapy department multiple times, and treatment for thoracic malignancies was initiated in 161 patients. The female:male ratio was 27%:73%, and the patients’ median age(range)was 68 years(range:36—84 years). Lung cancer was the most common disease(91%), followed by malignant pleural mesothelioma(5%), thymoma(2%), thymic carcinoma(1%), and synovial sarcoma(1%). The most common histological type of lung cancer was adenocarcinoma(67%), followed by squamous cell carcinoma(17%), small cell carcinoma(7%), and others(9%). Outpatient chemotherapy was introduced as a first—line, second—line, and third—line or later treatment in 46%, 28%, and 22% of cases, respectively. While the number of patients increased, the number of new patients with thoracic malignancies decreased from 58 in FY2016 to 52 in FY2017 and 51 in FY2018. Conversely, the number of visits to the chemotherapy department by each new patient almost doubled from 5.5 in FY2016 to 8.5 in FY2017 and 10.1 in FY2018. The proportion of patients for which immunotherapy was included in the induction treatment regimen increased from 28% and 24% in FY2016 and FY2017, respectively, to 39% in FY2018. The increase in the use of outpatient chemotherapy for respiratory thoracic malignancies was due to the increase in the proportion of patients undergoing immunotherapy and the number of visits to the chemotherapy department per patient. It is important to implement measures to help prolong and increase the use of outpatient pharmacotherapy for respiratory thoracic malignancies by cooperating with surrounding medical institutions and increasing the number of beds available.
要旨
肺癌など呼吸器系胸部悪性疾患についての動向を知るため,2016年4月～2019年3月までの3年間で当院外来薬物療法について調査を行った。3年間の外来化学療法室全利用者は19,408名で,呼吸器系胸部悪性疾患利用者(胸部利用者)は1,270名(6.5%)であった。3年間の推移は全利用者,胸部利用者(%)の順に2016年度5,815件,320件(5.5%),2017年度6,344件,434件(6.8%),2018年度7,247件,516件(7.1%)であり,各利用者数および胸部の全体に対する割合も増加していた。1人の患者が複数回利用しており,新規に利用した胸部患者161名を検討した。利用者は,女性/男性:27%/73%,年齢中央値(範囲):68(36～84)歳,疾患は肺癌が最も多く(91%),次いで悪性胸膜中皮腫(5%)/胸腺腫(2%)/胸腺癌(1%)/滑膜肉腫(1%),肺癌の組織型は腺癌(67%)/扁平上皮癌(17%)/小細胞癌(7%)/その他(9%),外来薬物療法が導入された時期は一次治療(46%)/二次治療(28%),三次治療以降(22%)であった。利用者数が増加する一方で,新規胸部利用者は2016年度58名,2017年度52名,2018年度51名と減少し,新規利用者1人当たりの利用回数はそれぞれ5.5/8.5/10.1回とほぼ2倍に増加していた。導入治療レジメンにおける免疫療法の割合が28/24/39%と増加していた。呼吸器系胸部外来化学療法数の増加は免疫療法の割合が増加し,1人当たりの外来化学療法室利用回数が増加していることがその原因であった。周囲の医療機関との協力や増床などによる外来薬物療法の長期化と増加への対策が必要である。