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Toxicity Profile of Temozolomide in the Treatment of 300 Malignant Glioma Patients in Korea
배소현,박민정,이민미,김태민,이세훈,Sung Yun Cho,김영훈,김유정,박철기,김재용 대한의학회 2014 Journal of Korean medical science Vol.29 No.7
This study evaluated the toxicity profiles of temozolomide in the treatment of malignantglioma as either concurrent or adjuvant chemotherapy. We retrospectively reviewed themedical records of 300 malignant glioma patients treated with temozolomide in twomedical institutions in Korea between 2004 and 2010. Two hundred nine patientsexperienced a total of 618 toxicities during temozolomide therapy. A total of 84.8% of the618 toxicities were Common Terminology Criteria for Adverse Events (CTCAE) grade 1 or 2,while 15.2% were grade 3 or 4. Among the hematologic toxicities, thrombocytopenia(13.7%), anemia (11.0%), and AST/ALT increases (7.0%) were common. Among the nonhematologictoxicities, nausea (44.3%), vomiting (37.0%), and anorexia (14.3%) were thethree most common toxicities. There was no mortality due to temozolomide. Althoughtemozolomide showed many types of toxicities, the majority of the toxicities were tolerableand of lower grade. Gastrointestinal troubles are the most common toxicities in Koreanpatients treated with temozolomide.
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김은희,김철규,이순교,김순덕,이혜옥,권정순,이경미,이민미,심순미,유용만,신종식,강은희,이상일,김병식,오성태,육정환,박수길 한국의료QA학회 2003 한국의료질향상학회지 Vol.10 No.2
Background : Gastric cancer is the most common malignant tumor in Korea. surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for recucing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and unplanned readmission rate between the pre-pathway group(n=67) and the post-pathway group(n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days(p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was of satistically significant(p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korea hospital settings.
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