1.Effect analysis of clinical pharmacists participating in national medical insurance negotiation of new anti-tumor drug MDT management mode
Weijia XU ; Yueyun XIE ; Liling XU ; Han ZHOU ; Haiyu HUANG ; Zhao QIN ; Qian HUANG ; Hua XIAO ; Xue WU
Chongqing Medicine 2025;54(1):114-120
Objective To explore the effect of management model of clinical pharmacists participating in multidisciplinary collaborative diagnosis and treatment(MDT)for new anti-tumor drugs in the national medical insurance drug negotiation(hereinafter referred to as"national negotiation"),including efficacy,safe-ty,economy and rationality.Methods The medical records of 326 cases using novel anti-tumor drugs by na-tional negotiation and conforming to the including and excluding standards in this hospital from July 2018 to June 2023 were retrospectively analyzed.The patients were divided into the MDT group(n=122)and non-MDT group(n=204).The patients diagnosed as non-small cell lung cancer(NSCLC)in the two groups were extracted and defined as the MDT-NSCLC subgroup(n=41)and non-MDT-NSCLC subgroup(n=77).The progression-free survival(PFS),overall survival(OS),disease control rate(DCR)and the indexes such as survival quality and medical quality control were compared between the groups.Results The median PFS in the two groups was 12.7 months and 8.0 months,the median OS was 75.2 months and 56.3 months,DCR was 96.72%and 81.86%respectively,and the differences were statistically significant(P<0.05).The COX multivariate regression analysis indicated that the HR value of clinical pharmacists participating in MDT was higher than the other influencing factors.The median PFS time in the MDT-NSCLC subgroup and non-MDT-NSCLC subgroup was 10.5 months and 6.7 months,DCR was 97.30%and 75.64%respectively,and the differences were statistically significant(P<0.05),the median OS time was 55.1 months and 40.3 months respectively,and the difference was statistically significant(P>0.05).The COX multivariate regression anal-ysis indicated that the HR value with clinical pharmacists participating in MDT was higher than the other in-fluencing factors;The adverse reaction occurrence rate in the MDT group and non-MDT group was 45.9%and 58.3%respectively,and the difference was statistically significant(P<0.05).The KPS score after treatment in the MDT group was higher than that in the non-MDT group,and the difference was statistically significant;in the aspect of medical quality control,the average drug proportion in the MDT group and non-MDT group was 63.93%and 64.54%respectively,the rational drug rate of comments on prescription was 98.36%and 88.73%respectively,the patient satisfaction average value was 90.69 points and 87.36 points respectively and the differences were statistically significant(P<0.05).Conclusion Clinical pharmacists participating in MDT related to novel anti-tumor drugs by national negotiation is beneficial to improve the therapeutic effects,living quality and patient satisfaction,also benefit to management and control of off-label drug use and medical quality control indexes.
2.Clinical study of the treatment of elderly advanced malignant tumor by radioactive 125I seed implantation
Yueyun XIE ; Xueyuan LIU ; Zhongping BAO ; Qing REN
Cancer Research and Clinic 2012;24(6):414-416
Objective To investigate the efficacy of CT guided radioactive 125I seed implantation on elderly patients with advanced malignancies.Methods 78 cases of elderly patients with malignant were collected and divided into two groups.41 cases of the treatment group were treated with CT guided radioactive 125I seed implantation.Particle activity was 29.6 MBq.The prescription dose was 90-110 Gy.37 cases of the control group were treated with optimized supportive care.Data from all of patients were to review and followup observation in short term efficacy,quality of life and side efforts.Results The total effective rate was 92.7 %(38/41)and the disease control rate was 97.6 %(40/41)in the treatment group.The control group was in the effective rate and 16.2 %(16/37)in the disease control rate.The quality of life of the treatment group was higher than those in the control group(P<0.05).And there is no obviously side efforts.Conclusion The treatment of elderly patients with advanced malignant tumors by 125I seed implantation was a safe and effective method.It can improve the quality of patients' life.
3.Effect of CT-guided implantation of radioactive ~(125)I seeds on the residual foci of nasopharyngeal carcinoma after radiotherapy
Yueyun XIE ; Jingwu WU ; Hongzhi WANG ; Xiurong TIAN ; Zhongping BAO
Tumor 2009;(12):1170-1172
Objective:To evaluate the efficacy of computed tomography (CT)-guided implantation of radioactive ~(125)I seeds in the treatment of residual foci of nasopharyngeal carcinoma after radiotherapy.Methods:Twenty-five nasopharyngeal carcinoma patients who had residual foci after radiotherapy were implanted radioactive ~(125)I seeds from January 2007 to January 2008 in our hospital. Three-dimensional treatment planning system (TPS) was used to calculate the quantity and total dosage of ~(125)I seeds. The radioactive ~(125)I seeds were implanted into residual foci under CT guidance. The dosage distribution of radioactive ~(125)I seeds were verified after surgery. The nasopharyngeal endoscopy CT scans were performed at 3, 6, and 12 months after surgery and the short-term efficacy and adverse reaction were evaluated. Results:Out of the 25 patients, 20 patients had complete response (CR), 2 patients had partial response (PR), 2 patients had no change (NC), and 1 patient had progressive diseases (PD). The overall effective rate (CR+PR) was 88.0%. All patients had no serious postoperative complications. Conclusion:CT-guided implantation of radioactive ~(125)I seed was an effective and safe method in the treatment of the residual foci of nasopharyngeal carcinoma after radiotherapy.

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