Effectiveness of Interdisciplinary Team Conference to Manage Skeletal Related Events in Rehabilitation for Patients with Cancer

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  • HAYASHI YASUKO
    Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine
  • NAGAOKA MASANORI
    Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine
  • TAKAGI TATSUYA
    Department of Orthopedic Surgery, Juntendo University Graduate School of Medicine
  • KITAHARA ERIKO
    Division of Rehabilitation, Juntendo University Hospital
  • HATORI KOZO
    Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine
  • TERAKADO ATSUHIKO
    Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine
  • IZAWA NANA
    Department of Rehabilitation Medicine, Juntendo University Graduate School of Medicine

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Objective: We started a skeletal related events (SRE) management team to conduct rehabilitation interventions safely in cancer patients with metastatic bone lesions. SRE conferences were held 24 times from April 2011 to April 2012. Based on this experience, we investigated how the conferences benefited these patients.<br>Participants: 78 individual patients (36 males and 42 females; aged 12-84 years, mean 63.6 years) were discussed in SRE conferences. Some became the subject of discussion repeatedly, and a total of 120 patients were discussed.<br>Methods: This report analyzed retrospectively the effects of SRE conferences on the patients.<br>Results: Primary cancers included breast cancer in 21 patients, lung cancer in 19, renal cancer in 7, liver cancer in 7, prostatic cancer in 6, esophageal cancer in 3, and gastric cancer in 3, and others in 12. No patients sustained pathological bone fracture during rehabilitation interventions. Rehabilitation achieved the goal of mobility in 75% of patients. Through substantial discussions within the interdisciplinary team, 16 patients with critical bone lesions assumed anti-gravity posture on average 4.4 days after (minimum 6 days before, maximum 23 days after) completion of radiotherapy. This was clearly earlier than the empirical schedule of around 2 weeks. The proportion of patients who were discharged to their own home increased significantly since SRE conference was started, compared to the pre-SRE conference period between 2006 and 2007.<br>Conclusion: The present study suggests that implementation of SRE conference for cancer patients with bone metastases is effective to improve activity level with low risk of inducing pathological fracture, and is useful to achieve patients’ goals including mobility improvement and independent ADL.

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