2. 抗がん剤の使われ方-その問題点の所在をめぐって-

抄録

Objective and Data Sources : To clarify where the crux of the problems lies in general usage of anticancer drugs in Japan, we examined the tracking reports on leading products in cancer market during 1994-1996. The results obtained were compared with 1995-6's actual purchase in National Cancer Center (NCC), Japan, and those in 1996 from the M. D. Anderson Cancer Center (MDACC), USA.
Results : In Japan, oral agent of fluoropyrimidine such as UFT, doxifluridine (Furtulon), or 5-FU tablet, immunopotentiator such as Picibanil or Krestin, and anticancer hormonal agents accounted for approximately 70% of the market. As a result, the cytocidal anticancer injections which should be the leading agents for cancer chemotherapy are in the minority. In contrast, the actual purchase of NCC revealed that approximately 85% was for the cytotoxic injections and it was nearly the same with MDACC. In spite of this, the actual purchase for granulocyte colony stimulating factors (G-CSF) and antiemetics such as granisetron was so much larger in MDACC (30% of the total) that in NCC (7% of the total).
Conclusion : The special circumstances in Japanese market reflects the poor development of medical oncology in this country where the truth-telling is uncommon, and less toxic chemotherapy is chosen without considering how much actually effective. Although, on the other hand, the similarity in NCC and MDACC indicates the expertness of cancer treatment, so big expense for G-CSF and antiemetics in USA makes us consider the importance of the rationalization for their usage in toxic chemotherapy in Japan.