高齢者機能評価とレジメンでわかる がん薬物療法

出版社: 中外医学社
著者:
発行日: 2022-09-30
分野: 臨床医学:一般  >  薬物療法
ISBN: 9784498117204
電子書籍版: 2022-09-30 (1版1刷)
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高齢がん患者はそれぞれ多様な臨床背景をもち,薬物療法において容易に臨床試験のエビデンスを適用できないことも多い.本書の前半では,高齢がん患者の多様性や機能を客観的に評価するための具体的なツールを用い,どのように介入するかを解説.後半ではがん薬物療法の代表的なレジメンのコツと高齢者への注意点などを一目で分かるようにし,高齢者のがん薬物療法の実践の一助となる一冊となっている.

目次

  • I 高齢者のがん薬物療法の考え方

    A.高齢者の意思決定と有害事象の特徴
     1.がん領域での高齢者機能評価
      1.高齢がん患者の治療方針決定
      2.高齢者機能評価とは
      3.ガイドラインでの推奨
      4.GAに基づくマネジメントの有用性
     2.がん薬物療法を受ける高齢がん患者の意思決定支援
      1.がん薬物療法における高齢者支援の現状
      2.がん薬物療法を受ける高齢者のヘルスリテラシー
      3.高齢者の意思決定支援
      4.高齢者の意思決定能力を高めるコミュニケーションの工夫
     3.高齢がん患者の有害事象の特徴とケア
      1.高齢者のがん薬物療法における有害事象の特徴
      2.治療開始前のアセスメントと介入
      3.患者教育
      4.セルフケア支援
      5.症状マネジメントとケア

    B.高齢者機能評価のドメインと評価ツール
     1.生活機能
      1.パフォーマンスステータスについて
      2.日常生活動作(activities of daily living: ADL)
      3.手段的日常生活動作(instrumental activities of daily living: IADL)
      4.身体機能
      5.介入について
     2.薬物療法を受ける高齢がん患者を対象とした運動療法
      1.運動療法の目的
      2.運動療法のリスク管理と注意点
      3.運動療法の実際
     3.転倒・転落
      1.定義と予防の重要性
      2.発生状況
      3.要因
      4.がん薬物療法による転倒・転落リスクの増加
      5.転倒・転落リスクアセスメント
      6.転倒・転落を予防するためのケア
     4.併存症〈千田彰彦,浜本康夫〉
      1.併存症を評価する意義
      2.併存症の評価法
      3.併存症をもつ患者への介入
     5.栄養状態
      1.栄養管理の概要
      2.栄養障害のスクリーニング
      3.栄養アセスメント
      4.がんの病状・治療方針
     6.食事指導
      1.高齢者のがん薬物療法と食事指導
      2.必要栄養量の算出と食事指導・栄養支援
      3.がん薬物療法施行時の有害事象と食事指導・栄養支援
      4.経口栄養補助食品(oral nutritional supplements:ONS)と食事指導・栄養支援
     7.認知機能
      1.がん治療と認知機能
      2.認知機能検査とその役割
      3.主要な認知機能検査
      4.介入
      5.認知機能障害のある場合の対応
     8.がん薬物療法とポリファーマシーについて
      1.ポリファーマシーの背景とその影響
      2.処方適正化のための基準
      3.がん薬物療法中のポリファーマシー対策と工夫
     9.ポリファーマシーへの薬学的介入
      1.がん患者におけるポリファーマシーの問題点
      2.ポリファーマシーと薬学的介入の現状
      3.薬剤師の役割
     10.服薬アドヒアランスと看護
      1.服薬アドヒアランスに影響を与える要因
      2.服薬を支援するためのアセスメント
      3.服薬アドヒアランスを高めるための看護師の役割
      4.服薬支援の実際
     11.精神状態・気分
      1.高齢がん患者における気分障害の特徴
      2.評価ツール
      3.高齢がん患者に自記式質問票を用いる問題点
      4.高齢がん患者の抑うつに対する介入
     12.社会的サポート
      1.高齢がん患者の社会的フレイル
      2.評価ツール
      3.高齢がん患者の社会的サポート介入

    C.高齢者機能評価スクリーニングツールと有害事象予測ツール
     1.高齢者機能評価スクリーニングツール
     2.高齢者機能評価を用いた有害事象予測ツール

    II レジメンの実際と治療のコツ
    A.肺癌
     1.非小細胞肺癌 ドライバー遺伝子変異陰性(1)
      1)細胞傷害性抗がん薬+免疫チェックポイント阻害薬(ICI)
      2)カルボプラチン+アルブミン懸濁型パクリタキセル
     2.非小細胞肺癌 ドライバー遺伝子変異陰性(2)
      1)カルボプラチン+ペメトレキセド
      2)免疫チェックポイント阻害薬単剤
     3.非小細胞肺癌 ドライバー遺伝子変異陽性(1)
      1)オシメルチニブ単剤
      2)エルロチニブ+ラムシルマブ
     4.非小細胞肺癌 ドライバー遺伝子変異陽性(2)
      1)ゲフィチニブ単剤
      2)カルボプラチン+ペメトレキセド+ゲフィチニブ
     5.小細胞肺癌
      1)カルボプラチン+エトポシド
      2)アムルビシン

    B.消化器癌
     1.胃癌 術後補助
      1)S-1,ドセタキセル+S-1(DS)
      2)カペシタビン+オキサリプラチン(CAPOX)
     2.胃癌 転移再発
      1)S-1+オキサリプラチン(SOX)
      2)ラムシルマブ+パクリタキセル
     3.大腸癌 術後補助
      1)カペシタビン単剤
      2)カペシタビン+オキサリプラチン(CAPOX),FOLFOX
     4.大腸癌 転移再発
      1)カペシタビン+ベバシズマブ
      2)セツキシマブ単剤またはパニツムマブ単剤
     5.膵臓癌
      1)ゲムシタビン+アルブミン懸濁型パクリタキセル
      2)フルオロウラシル+レボホリナート+リポソーム型イリノテカン

    C.乳癌
     1.乳癌 術前・術後補助
      1)ドキソルビシン+シクロホスファミド(AC)
      2)毎週パクリタキセル
     2.ホルモン受容体陽性乳癌 転移再発
      1)アロマターゼ阻害薬単剤
      2)フルベストラント
     3.乳癌 転移再発(抗HER2療法を除く(1))
      1)エリブリン
      2)ベバシズマブ+パクリタキセル
     4.乳癌 転移再発(抗HER2療法を除く(2))
      1)S-1単剤
      2)アテゾリズマブ+アルブミン懸濁型パクリタキセル
     5.HER2陽性乳癌 術後補助
      1)パクリタキセル+トラスツズマブ
     6.HER2陽性乳癌 転移再発
      1)ペルツズマブ+トラスツズマブ+ドセタキセル

    D.造血器腫瘍
     1.悪性リンパ腫
      1)R-CHOP
      2)ベンダムスチン+リツキシマブ(BR)
     2.慢性リンパ性白血病(CLL),多発性骨髄腫
      1)慢性リンパ性白血病(CLL):イブルチニブ単剤
      2)多発性骨髄腫(MM):ダラツムマブ+レナリドミド+デキサメタゾン(DLd)

    E.泌尿器系腫瘍
     1.前立腺癌 去勢抵抗性
      1)ドセタキセル+プレドニゾロン
      2)カバジタキセル+プレドニゾロン
     2.腎癌
      1)アキシチニブ+ペムブロリズマブ
      2)イピリムマブ+ニボルマブ

    F.婦人科腫瘍
     1.卵巣癌
      1)パクリタキセル+カルボプラチン(毎週分割投与,weekly TC)
      2)ゲムシタビン
     2.子宮内膜癌
      1)ドキソルビシン+シスプラチン(AP)
      2)パクリタキセル+カルボプラチン(TC)
     3.子宮頸癌
      1)パクリタキセル+シスプラチン+ベバシズマブ
      2)パクリタキセル+カルボプラチン(TC)

    G.その他
     1.原発不明がん
      1)パクリタキセル+カルボプラチン
     2.転移性脳腫瘍

この書籍の参考文献

参考文献のリンクは、リンク先の都合等により正しく表示されない場合がありますので、あらかじめご了承下さい。

本参考文献は電子書籍掲載内容を元にしております。

I 高齢者のがん薬物療法の考え方

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