大腸がんは国内において増加傾向であり,近い将来, 胃がん,肺がんを抜いて日本人に最も多くみられるがん になることが予測されている.それに伴い大腸がんの化 学療法も飛躍的に進歩してきた.治癒切除不能な進行再 発大腸がんにおいては,全生存期間中央値が 28 カ月にま で達した 1) . 経口剤と注射剤を組み合わせた XELOX 療法は, 既 存の標準治療である FOLFOX4 療法を比較対象とした NO16966 試験の結果,主要評価項目である無増悪生存期 間において非劣性であることが報告されている 2) .XELOX 療法は,3 週間に 1 回とFOLFOX 療法と比較して少ない 通院回数で治療可能である点と 5-FU の持続点滴を必要と しない点において,FOLFOX 療法より臨床応用しやすい 治療法であると考えられる. しかし,経口抗がん剤が十分な治療効果をあらわすた めには,患者自身が自宅で適切な量を適切な期間服用す ることが前提である.治療成功のためには服薬サポート 体制とコンプライアンスの確認が必要であり,そのため に薬剤師の果たすべき役割が大きいと思われる. XELOX

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... における薬剤師外来の有用性 XELOX (capecitabine plus oxaliplatin) is a standard treatment for unresectable advanced colorectal cancer. Combining oral and intravenous administration, it is convenient method of treatment but full patient compliance regarding capecitabine is necessary to obtain efficacy. To help ensure good patient compliance for this drug, we established a pharmaceutical outpatient clinic at the Cancer Institute Hospital of the Japanese Foundation for Cancer Research (JFCR) where pharmacists interview patients prior to physicians' assessments. Medication compliance and adverse effects are investigated, and supportive care and prescription support provided. In this study, we evaluated the usefulness of the pharmaceutical outpatient clinic. We retrospectively investigated colorectal cancer patients who had received treatment with XELOX or XELOX + bevacizumab in our hospital. The end points included the number and content of inquiries concerning XELOX and the adoption rate of suggestions made regarding supportive care. In the results, inquiries concerning XELOX were made for 5.3% (14 / 260) of patients in a pharmaceutical intervention group (post-pharmaceutical outpatient clinic), in contrast to 16.8% (43 / 256) for a control group (no consultation in pharmaceutical outpatient clinic). The number of inquiries was significantly lower in the pharmaceutical intervention group than in the control group (p < 0.001). In the pharmaceutical intervention group there were no inquiries about dosage. At 95.4%, the adoption rate for 592 prescription suggestions was very high. The results of our study indicate that the pharmaceutical outpatient clinic was useful for patients prescribed XELOX.