The rate of extramural prescription in Nagoya Memorial Hospital is approximately 90％ and most of our patients receive medicine in health insurance pharmacies. However, there are several problems in the prescriptions for outpatients; the patients are sometimes unable to obtain the prescribed drugs because they are out of stock in the family pharmacy. In addition, community pharmacists find it difficult to instruct individual patients when obtaining information only through externally dispensed prescriptions. To improve the cooperation between our hospital and community pharmacists, we performed a questionnaire survey on the present status of cancer patients and then another on pharmacists working in health insurance pharmacies. The first series of questionnaires showed that all patients had a family pharmacy and 92％ of them agreed to give their information to it. In addition, the patients being prescribed oral cancer drugs would more often consult the community pharmacists, compared to those receiving parenteral chemotherapeutic agents. The second series of questionnaires for community pharmacists revealed that around 90％ were interested in obtaining more information from their hospital, although less than one fifth of them could talk to patients undergoing cancer treatment. Based on these results, we discussed with community pharmacists and designed a communication form of cooperation. The form of cooperation was sent from the hospital to the health insurance pharmacy by FAX, after obtaining informed consent from the patients. This form is to be evaluated from the viewpoints of patients and community pharmacists and then further improved.

Objective: Bevacizumab has been increasingly used in combination chemotherapy for the treatment of metastatic or recurrent colorectal cancer. The aim of this report is to underline the possible risks associated with bevacizumab use. Methods: Between July 2005 and March 2013, a total of 130 patients with metastatic colorectal cancer who received oxaliplatin as first-line chemotherapy were divided into 2 groups those treated with bevacizumab (group A) and those without (group B), and compared. The primary endpoint was to clarify the profile of bevacizumab-induced adverse effects. Secondary endpoints examined therapeutic effects, including overall survival (OS). Results: The incidence of major side effects was almost equivalent, except for bleeding, between the 2 groups. With regard to the therapeutic effects, 1 patient in group A showed complete disappearance of multiple lung metastases without any evidence of recurrence. The median OS was 926 days (95% confidence interval [CI], 756-1257) in group A and 534 days (95% CI, 421-621) in group B (p < 0.01). Conclusion: The results demonstrate that bevacizumab prolonged survival in these patients although there was an increased risk of clinically significant bleeding.

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This comprehensive geriatric assessment was useful for predicting the longevity of patients with stage 4 gastric cancer ≥ 75 years of age.

rate was 90.9%. The present survey revealed that in seeing the patients the regional health care professionals did check each part of the tools described by multidisciplinary staff; MSW (question item #1, #4), physician (#2, #3, #5), pharmacist (#5), therapist (#6), and palliative care team (#7, #8). The tools invented by Higashi-Nagoya home care social gathering should be useful (10/12) (#9) and enhance the quality of palliative care (12/12) (#10). Conclusions Sharing information via the communication tools of cooperation might contribute to realizing the seamless palliative care in the region adjacent to our hospital.