• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.2329-2336
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• 2016

Background: Despite the existence of established guidelines advocating the use and value of chemotherapy order templates, chemotherapy orders are still handwritten in many hospitals in Lebanon. This manuscript describes the implementation of standardized chemotherapy order templates (COT) in a Lebanese tertiary teaching hospital through multiple steps. Initial Assessment: An initial assessment was conducted through a retrospective appraisal of completeness of handwritten chemotherapy orders for 100 adult patients to serve as a baseline for the project and identify parameters that might afford improvement. Choice of solution: Development of over 300 standardized pre-printed COTs based on the National Comprehensive Cancer Network templates and adapted to the practice culture and patient population. Implementation: The COTs were implemented, using Kotter's 8-step model for leading change, by engaging health care providers, and identifying and removing barriers. Evaluation: Assessment of physicians' compliance with the new practice (122 orders assessed) was completed through two phases and allowed for the identification of areas of improvement. Lessons Learned: Overall, COT implementation showed an average improvement in order completion from 49.5% (handwritten orders) to 77.6% (phase 1-COT) to 87.6% (phase 2-COT) reflecting an increase of 38.1% between baseline and phase 2 and demonstrating that chemotherapy orders completeness was improved by pre-printed COT. As many of the hospitals in Lebanon are moving towards standardized COTs and computerized physician order entry (CPOE) in the next few years, this study provides a prototype for the successful implementation of COT and demonstrates their role in promoting quality improvement of cancer care.

• Korean Journal of Clinical Pharmacy
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• v.17 no.1
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• pp.1-5
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• 2007

A computerized chemotherapy order system (CCOS) was developed to improve the accuracy and efficiency of prescriptions for pharmacy medication scheduling at a teaching hospital, Asan Medical Center, Seoul, Korea. We evaluated the system by comparing prescriptions before and after the implementation of the system and by analyzing the effects of the system on dosing accuracy (only against 5-FU), prescription change, overdoses above maximum limit and medication disposal in non computerized program group (control group) and CCOS group. In terms of dosing accuracy, prescription error rate (%) was significantly decreased in CCOS groups compared with the control group. The rate of prescription changes was also significantly decreased in CCOS groups. Regarding overdoses above maximum limit, we found that there was no prescription order exceeding the dosage limit in CCOS groups in contrast to significant overdoses in control group. In terms of medication disposal, there was no significant difference between 2 groups. We suggest that the computerized chemotherapy order system for chemotherapy may bean important and useful tool for minimizing prescribing errors in the hospitals.

• Journal of Korean Academy of Nursing
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• v.32 no.2
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• pp.206-219
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• 2002

This study was conducted to investigate nutrient and food choices in gastric cancer patients receiving Cisplatin after surgery. Ten patients were followed from the fist day of the first cycle to the last date of the 6th the cycle of the chemotherapy. The subjects kept daily self record of dietary intake and the period of nausea/vomiting during 6 cycles. Using Computer Aided Nutritional Analysis Program, the degree of Calorie, carbohydrate, protein, fat and fluid intakes according the chemotherapy period. The reseacher developed food intake rating scale, and then three dietitians analysed the oral intakes according to the type of foods. As the results of this study, during the chemotherapy cancer patients are intakes much fewer calorie, protein and fluids than recommended dietary allowance. Oral intake was worsen as treatment proceed. During the chemotherapy periods most of the patients choose fruits, vegitables, steam rice, porridge, yogurt and the beam soup to overcome nausea and vomiting. In order to promote oral intake for chemotherapy patients, the researcher strongly suggest that indiviual food preform should be considered.

• Journal of Korean Neurosurgical Society
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• v.30 no.sup2
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• pp.266-272
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• 2001

Objectives : Chemotherapy remains part of the treatment triad that includes surgery and radiotherapy for the management of glioblastomas, but disappointing results of chemotherapy have raised the suggestion that chemotherapy should perhaps be abandoned. In order to determine the chemotherapy effect given in addition to radiotherapy, we performed a randomized clinical study of irradiation alone and combination of irradiation with chemotherapy in the treatment of glioblastomas. Methods : From 1991 to 1999, 204 consecutive patients suffering from supratentorial glioblastomas were treated in our hospital. We compared the survival rates/times of these patients according to the treatment modalities[group I-67 patients treated by surgery with radiotherapy and adjuvant chemotherapy(ACNU, paclitaxel, tamoxifen, and others) ; group II-106 by surgery with radiotherapy ; and group III-31 by surgery only]. Results : The overall median survival time was 12 months, with overall survival rates at 1 and 2 year of 46.7% and 16.6%, respectively. On univariate analysis, median survival and 1- and 2-year survival rates were statistically improved by the use of chemotherapy ; group I-15 months, 75.7%, and 25.9%, group II-11 months, 39.3%, and 15.4%, and group III-3 months, 9.7%, and 6.5%, respectively(p=0.0001). But, on multivariate analysis considering compounding variables, survival was independently associated only with radiotherapy(p=0.0112). Conclusion : These results suggest that the addition of chemotherapy to radiotherapy does not affect the overall survival in glioblastomas. Mainly long-survivor glioblastoma patients might benefit by adjuvant chemotherapy, which probably means patients with initial favorable prognostic factors(young age, minimal residual tumors, good performance status). It is necessary to continue to search for an effective chemotherapy regimen to prolong survival of patients with glioblastomas.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.3
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• pp.1181-1185
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• 2016

Background: The aim of this study is to compare the numbers of axillary lymph nodes (ALN) taken out by dissection between patients with breast cancer operated on after having neoadjuvant chemotherapy (NAC) treatment and otherswithout having neoadjuvant chemotherapy, and to investigate factors affecting lymph node positivity. Materials and Methods: A total of 49 patients operated due to advanced breast cancer after neoadjuvant chemotherapy and 144 patients with a similar stage of the cancer having primary surgical treatment without chemotherapy at the general surgery clinic of Ondokuz Mayis University Medicine Faculty between the dates 01.01.2006 and 31.10.2012 were included in the study. The total number of lymph nodes taken out by axillary dissection (ALND) was categorized as the number of positive lymph nodes and divided into <10 and ${\geq}10$. The variables to be compared were analysed using the program SPSS 15.0 with P<0.05 accepted as significant. Results: Median number of dissected lymph nodes from the patient group having neoadjuvant chemotherapy was 16 (16-33) while it was 20 (5-55) without chemotherapy. The respective median numbers of positive lymph nodes were 5 (0-19) and 10 (0-51). In 8 out of 49 neoadjuvant chemotherapy patients (16.3%), the number of dissected lymph nodes was below 10, and it was below 10 in 17 out of 144 primary surgery patients. Differences in numbers of dissected total and positive lymph nodes between two groups were significant, but this was not the case for numbers of <10 lymph nodes. Conclusions: The number of dissected lymph nodes from the patients with breast cancer having neoadjuvant chemotherapy may be less than without chemotherapy. This may not always be attributed to an inadequate axillary dissection. More research to evaluate the numbers of positive lymph nodes are required in order to increase the reliability of staging in the patients with breast cancer undergoing neoadjuvant chemotherapy.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7701-7705
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• 2015

Background: Thyroid hormones (TH) are regulated by the hypothalamic-pituitary axis, which plays an important role in cell growth, differentiation, development and other aspects of metabolism. It is believed that an active hypothalamic-pituitary axis increases the susceptibility of thyroid dysfunction during systemic chemotherapy. In order to investigate the relation between thyroid function and chemotherapy the present study was designed to investigate TH in breast cancer patients receiving at least three cycles of chemotherapy. The levels of TH were measured at the baseline and before each cycle of chemotherapy. Materials and Methods: Blood samples for estimation of TH levels were collected from 80 (pre-menopausal-40; post-menopausal-40) breast cancer patients just before they were undergoing - $1^{st}$, $2^{nd}$, $3^{rd}$ and $4^{th}$ cycle of chemotherapy. The serum was separated and $T_3$, $T_4$ and TSH levels were determined by chemiluminescence method. Results: $T_3$ and $T_4$ were found significantly decreased and TSH was found significantly increased after $1^{st}$ (p<0.001), $2^{nd}$ (p<0.0001) and $3^{rd}$ cycle of chemotherapy (p<0.0001). The variation of $T_3$ levels (decreased) and TSH levels (increased) was found more in post-menopausal (p<0.0001) women then in pre-menopausal women after $3^{rd}$ cycle of chemotherapy as compared to baseline (p<0.001). Conclusions: TH were remarkably altered after each cycle of chemotherapy leading to decline in thyroid function of breast cancer patients. Further, the results also indicated that post-menopausal women were more prone towards decline in thyroid function then pre-menopausal women. The present study proposes the monitoring of TH after each cycle of chemotherapy in breast cancer patients.

• Journal of Korean Traditional Oncology
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• v.12 no.1
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• pp.83-89
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• 2007

Chemotherapy has many known side effects. Neuropathy is a common side effect when using cisplatin. The clinical course varies and depends on the agents used and their cumulative dose. Although symptoms can resolve completely, in most patients chemotherapy-induced peripheral neuropathy is either only partially reversible or completely irreversible. Current management for chemotherapy-induced peripheral neuropathy is symptomatic relief using membrane stabilizing medications and antidepressants. Dysaesthesia and pain involving the feet and hands are described in traditional korean medicine. In traditional korean medicine, the pathogenesis is related to the inability to direct Qi and Blood to the extremities, and is associated with Qi, Blood, Yang and Kidney deficiencies. We report a case of a 52 years old female patient treated with acupuncture and bleeding treatment for the goal of improving the symptoms of chemotherapy induced peripheral neuropathy. Further study and other medical method will be needed in order to improve the effect and determine the long-term effect of traditional korean medicine in treating Chemotherapy-induced Peripheral Neuropathy.

• Journal of Haehwa Medicine
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• v.23 no.2
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• pp.23-32
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• 2015

Objective : The purpose of this study was to examine the level of the cognitive function, and to identify the influencing factors on cognitive function in women cancer patients receiving chemotherapy. This study attempted to provide basic data useful to development of nursing intervention and improve the quality of life in women cancer patients. Methods : As a cross-sectional descriptive study, women with receiving chemotherapy above one cycle were recruited. One hundred and twenty-five women cancer patients who met the study criteria agreed to participate in the study. The questionnaire set consisted of cognitive function, quality of life, depression, anxiety and information on demographic and clinical characteristics. Results : There was no statistically significant difference in clinical characteristics according to the cognitive function. The cognitive function was higher the more low age (F=9.937, p<.001), and the more high education level (F=12.332, p<.001). Multiple regression analysis showed the predictors were significantly related to cognitive function. age, education, and the number of chemotherapy explained 31.8% of the cognitive function. Conclusions : This result of this study provides basic information about factors influencing cognitive function, although study findings are insufficient in explaining related variables among women cancer patients. Even though women cancer patients were receiving chemotherapy, this study showed that the level of cognitive function was high. In order to receive better results and findings the period decreasing cognitive function, further studies are need to measure cognitive function according to the passage of time during or after chemotherapy.

• Journal of Korean Academy of Nursing Administration
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• v.21 no.3
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• pp.254-262
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• 2015

Purpose: This study was done to apply failure mode & effect analysis (FMEA) to chemotherapy in order to reduce prescribing, dispensing and administering errors related to treatment and provide patients with a safe medical environment. Methods: A one group pre-post test design was used to verify the effects using the tool for FMEA in chemotherapy. Results: There was a statistically significant decrease in prescribing errors from 11.47% to 3.18%; administering errors decreased but they were not statistically significant. In a addition, there was no change in dispensing errors. Conclusion: The results show that FMEA removed risk factors that might occur during the process of chemotherapy and that it was an effective tool for prevention of negligent accident occurring in actual patients.

• Korean Journal of Clinical Pharmacy
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• v.20 no.2
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• pp.120-127
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• 2010

Objective: The purpose of this study was to identify the type and frequency of chemotherapy-related prescribing errors and assess the pharmacist intervention in preventing potential harm. Methods: This study was performed in satellite pharmacy of oncology/hematology unit in tertiary teaching hospital from April to September, 2009. All chemotherapy prescribing errors detected by pharmacists were recorded. Frequency and characteristics of prescribing errors were analyzed. Pharmacists reviewed 28, 495 chemotherapy orders from 12,719 patients during 6-month periods. Results: A total of 835 prescription errors (2.93%) in 734 patients (5.77%) were detected by pharmacists. Alkylating agents (37.6%) followed by antimetabolite (23.35%), and mitotic inhibitors (21.44%) were the most prevalent classes in which errors occurs. The most common types of error detected were incorrect dose (34%), incorrect solution (33%), incorrect route (9%) and omission errors (8%). Changes in chemotherapy order due to pharmacists' intervention occurred in all error cases. Conclusion: Pharmacists' intervention in reviewing chemotherapy and drug orders intercepted potential harm due to prescribing errors. The current study provided strategies for reduction of medication errors.