[Outpatient chemotherapy for lung cancer]

In order to maintain the QOL in lung cancer patients and also save on medical costs, chemotherapy should be performed on an outpatient basis as much as possible. If the performance status is good and their residence is nearby, then not only in the case of small cell lung cancer or unresectable non-small cell lung cancer, but also including postoperative adjuvant chemotherapy for non-small cell lung cancer, in all such suitable cases, chemotherapy can be performed on an outpatient basis. For example, by performing outpatient chemotherapy in moderate amounts for older people, the survival can be improved while maintaining the QOL. However,a single dose of cisplatin 60 to 80 mg/m(2) requires a high volume iv infusion, and the first chemotherapy treatment needs to be carried out in the hospital for nausea and vomiting control. For a regimen of combined anticancer drugs other than cisplatin and including carboplatin, such as paclitaxel, docetaxel, irinotecan, gemcitabine or vinorelbine, the required iv time is short, side effects such as nausea or vomiting are less severe,and it is easily performed on an outpatient basis. An oral anticancer drug, gefitinib, or S-1 can also be an effective choice for non-small cell lung cancer. Since lung cancer patients tend to be susceptible to obstructive pneumonia or pneumonia from opportunistic infections, these need particular attention at the time of neutropenia. In addition, strict caution is required in order to prevent prescription or medication errors, or medical accidents such as leakage of the intravenous drip. If severe side effects occur, then a system must be prepared in which the patient can make contact promptly in emergency situations and thus can be hospitalized as necessary. Outpatient chemotherapy for lung cancers is increasing in Japan, however, there are many issues including insufficient staff, overworked staff, or situations where home nursing care places a heavy burden on the family. The assignment of sufficient medical treatment fees, the rationalization of work responsibilities or further development of home assistance systems are therefore eagerly anticipated.