Makoto Tahara

Evaluation of the impact of a flowchart-type leaflet for cancer inpatients.

Objectives: This study aimed to evaluate the benefits of an interactive and visual flowchart-type leaflet for head and neck cancer inpatients who received induction chemotherapy, docetaxel, cisplatin, and 5-fluorourasil (DCF), or docetaxel, cisplatin, and S-1 (DCS) from September 2009 to April 2012. The flowchart-type leaflet group used a flowchart-type leaflet during chemotherapy, while the non-flowchart-type leaflet group did not. Methods: A retrospective cohort study was performed using patient records. The endpoints of this study were to determine the following: the number of emergency hospital admissions/visits, incidence of Grade 2 or higher non-haematological adverse drug reactions, nonadherence to treatment, and the number of telephone calls from subjects. Results: A total of 109 subjects were identified as follows: 49 in the flowchart-type leaflet group (139 chemotherapy sessions) and 60 in the non-flowchart-type leaflet group (163 chemotherapy sessions). No significant differences were observed in age, performance status, or chemotherapy regimen. The incidence of emergency hospital admissions was significantly lower in the flowchart-type leaflet than in the non-flowchart-type leaflet group (1% vs 10%, p < 0.01). No difference was seen between groups (12% vs 19%, p = 0.1) in the nonadherence rate of supportive medication for adverse drug reactions. Telephone call rates were significantly higher in the flowchart-type leaflet (16%, 30 calls) than in the non-flowchart-type leaflet group (7%, 11 calls) in each chemotherapy regimen. Of the 30 calls from patients in the FCL group, 24 (80%) were made to the hospital, compared with only 5 (45%) of the 11 calls from patients in the non-flowchart-type leaflet group. Conclusions: Our results suggest that the flowchart-type leaflet can reduce nonadherence and improve patient judgment during chemotherapy, leading to a decrease in emergency hospital admissions.

998PINCIDENCE AND RISK FACTORS OF HYPOMAGNESEMIA IN HEAD AND NECK CANCER PATIENTS TREATED WITH CETUXIMAB

ABSTRACT Aim: Hypomagnesemia is an adverse event during cetuximab treatment. However, the incidence and risk factors of hypomagnesemia in head and neck cancer patients have not been clarified. The aim of this study is to identify clinical features and risk factors of hypomagnesemia caused by cetuximab-containing therapy in head and neck cancer patients. Methods: We retrospectively reviewed 113 head and neck cancer patients who received cetuximab-containing therapy from February 2012 to March 2014. Main eligibility criteria were ≥3 cetuximab administrations, no prior EGFR-directed therapy, and no prophylactic Mg supplementation. Results: Median baseline serum Mg level and number of cetuximab administrations were 2.2u2003mg/dl (range 1.8-2.6) and 8 (range 3-25), respectively. Overall incidence of hypomagnesemia was 46.9% (grade 1, 43.3%; grade 2, 2.6%; grade 3, 0%; grade 4, 0.8%) and differed between patients treated with bioradiation (cetuximab and radiation) and palliative chemotherapy (26% vs. 58%; p Conclusions: While prophylactic Mg supplementation is not absolutely necessary, special attention should be given to high-risk patients, namely those with low baseline Mg level, high number of cetuximab administrations, and concurrent platinum. Hypomagnesemia in high- and low- risk groups High-risk group Low-risk group (n = 53) (n = 15) p-value OR Median baseline Mg [mg/dl] (range) 2.2 (1.8, 2.6) 2.3 (1.9, 2.6) p = 0.23 - Median Δ Mg* [mg/dl] (range) -0.5 (0, -1.2) -0.3 (0, -0.8) p - Median Δ Mg %** [%] (range) -25 (0, -67) -13 (0, -31) p - Hypomagnesemia*** 66.0% 6.6% p 27.2 *Minimum Mg - Baseline Mg, **Δ Mg / Baseline Mg, ***All grades †Mann-Whitney U test, ‡Fishers exact test. Disclosure: All authors have declared no conflicts of interest.