Barcelona, spain- 3- 6 July, 2005
モンジュイックの丘から眺めたバルセロナ市街．
Supporting patients with lung cancer as multicenter co-operable clinical study Group of non-profit organization(NPO) in Japan (WJTOG)
West Japan Thoracic Oncology Group
Toshiyuki Sawa,M.D., Kenji Eguchi, M.D., Shinichiro Nakamura,M/D., Shinzo Kudo, M.D., Takashi Seto,M.D., Hideo Saka, M.D., Nobuyuki Katakami,M.D., Masahiro Fukuoka,M.D., Yutaka Ariyoshi,M.D.
Abstract
Background) West Japan Thoracic Oncology Group (WJTOG), non-profit organization conducted by volunteer thoracic oncologists, has mission to support multi-center clinical co-operable study for lung cancer and to inform the importance and necessity of clinical study widely, therefore to contribute improving social welfare. In Japan, patient advocacy is not popular, especially in lung cancer.
Method) to achieve the mission of WJTOG, we have played publicity activities for citizens as patient advocacy. To provide information to patients and their family, WJTOG carried out the following plan, 1) hold an open lecture for citizens, 2) provide information by web-site, 3) distribute video and PR brochure
Result) In this two years, 6 times of open lecture were held, and medical specialists for oncology, novelists with cancer, representative or president of organization for patients advocacy, and etc gave lecture and discussed with patients question. Nearly five hundred people had participated in each meeting, occupied by most women and senior citizens. The questionnaire survey to participant revealed satisfaction for lecture and expectation for next meeting. The contents of lecture appeared full page in the Asahi which has a large circulation of almost 8 million (the second position in the world) as well as Videotape and DVD-video was distributed widely to institute participating to our study and patients for the purpose of providing larger citizens with useful information. Furthermore WJTOG official web site show the detail of each lecture in Japanese because Japanese patients with lung cancer are old and difficult to read English web site.
Conclusion) it seems that WJTOG, non-profit organization, made patient advocacy to be more popular through open lecture, newspaper and web site.
世界肺癌学会に併せて開催された国際肺癌連合会議の後のガーデンパーティーにて
閉会式でフラメンコダンサー6人によるショー
Efficacy and survival benefit of prophylactic Shakuyaku-Kanzou-To for myalgia/arthralgia following Carboplatin and Paclitaxel combination chemotherapy for non-small cell lung cancer
T.SAWA, T.YOSHIDA, T.ISHIGURO, T.MIMORI, T.IKOMA, M.SAWADA, Y.OHNO, H.FUJIWARA
Division of Pulmonary Medicine and oncology, Gifu Municipal Hospital,
Gifu, Japan
Department of 2nd Internal Medicine, Gifu University,
Gifu, Japan
Carboplatin (CBDCA) and Paclitaxel (TXL) combination chemotherapy is one of the standard regimens for advanced non-small cell lung cancer, while myelosupression and myalgia/arthralgia are main adverse effects. Shakuyaku-Kanzou-To, a Japanese herbal medicine, is suggested to be useful to control myalgia/arthralgia induced by Paclitaxel. To evaluate the efficacy of NSAIDs and Shakuyaku-Kanzou-To combination treatment on myalgia/arthralgia, a comparative study was carried out in fifty patients with advanced or relapsed non-small cell lung cancer treated with CBADA +TXL. Patients were treated with more than 2 cycles of CBDCA (300-400mg/m2, or AUC5-6, day 1) + TXL (180-210mg/m2, day 1). Patients were assigned alternatively to two groups supported with prophylactic Shakuyaku-Kanzou-To and with only symptomatic NSAIDs. In the prophylactic Shakuyaku-Kanzou-To group, 7.5g/day of oral Shakuyaku-Kanzou-To was administered preventively through the chemotherapy. In the case of myalgia/arthralgia more than grade 2, NSAIDs was administered. Myalgia/arthralgia was classified into NCI-CTC grade and evaluated with score of grade by days.
The result was as follows.
1) Patients characteristics showed that mean age was 63.7 years old, pathological diagnosis were 32 cases of adenocarcinoma, 14 cases of squamous cell carcinoma and 4 cases of another carcinoma. In two groups, there was no difference in background of the patients.
2) Severity of myalgia/arthralgia was not significantly improved in the group with prophylactic Shakuyaku-Kanzou-To compared with the control group, while prophylactic Shakuyaku-Kanzou-To decreased score of grade by days. In the prophylactic Shakuyaku-Kanzou-To group, additional NSAIDs medication was significantly reduced.
3) Adverse effect of Shakuyaku-Kanzou-To was not observed, while hemorrhagic duodenal ulcer induced by NSAIDs was complicated in one patient.
4) Anti-tumor response showed overall response rate at 40% in prophylactic Shakuyaku-Kanzou-To and 16% in control group. MST was 12 months in prophylactic Shakuyaku-Kanzou-To and 10 months in control group respectively.
It is concluded that symptomatic treatment with NSAIDs and prophylactic treatment with Shakuyaku-Kanzou-To is useful to myalgia/arthralgia induced by Carboplatin and Paclitaxel combination chemotherapy and result survival benefit.
