Annual Report 2018
Department of Musculoskeletal Oncology and Rehabilitation
Akira Kawai, Fumihiko Nakatani, Eisuke Kobayashi, Shintaro Iwata, Tomoaki Mori, Takeshi Hirose, Junya Ueno, Miki Fujii, Yoshie Ino, Noriatsu Tatematsu, Yu Koishiwara, Tsuyoshi Harada, Nobuko Konishi, Keiko Sato
Introduction
The Department of Musculoskeletal Oncology and Rehabilitation of NCCHE is a team consisting of a panel of orthopedic surgeons and rehabilitation professionals that started in 2012. We strive to provide expert interdisciplinary care for a variety of benign and malignant bone and soft tissue tumors and tumor-like conditions, and we also provide comprehensive rehabilitation services. Currently, we have four orthopedic surgeons and five rehabilitation staff engaging in the treatment of a variety of patients with the aid of other orthopedic staff from NCCHE.
The Team and What We Do
Our outpatient service is generally open two days a week (Wednesdays, Fridays) for patients with a variety of musculoskeletal tumors or cancer patients who need rehabilitation care. We also manage patients who suffer from bone metastases and other orthopedic diseases, and consult with other cancer specialists on a daily basis. To provide prosthetic and orthotic care for our patients, a special outpatient service is open on Mondays. In cases where patients who need a multidisciplinary approach to treatment, we offer appropriate referral to the NCCH for further treatment. In September 2014, we opened a spacious rehabilitation unit with high-quality equipment with the aim to reduce common side effects of cancer treatment, including fatigue, weakness, poor endurance, pain, nausea, anxiety, depression and loss of confidence. As a result, we conducted rehabilitation treatment for 2,423 patients in 2018 (Table 1).
Table 1. Characteristics and number of patients enrolled for rehabilitation
Research activities
We have been focusing on regional cooperation with local physiotherapists in Kashiwa City with the aim to provide cancer patients in the community with seamless rehabilitation care after invasive cancer operations. Until now, we have established standard methods of physiotherapy and functional evaluations.
Clinical trials
We also have been focusing on the standardization of adjuvant and second-line chemotherapy regimens for bone and soft tissue sarcomas. Several multi-institutional clinical trials were conducted as follows:
1) A multi-institutional phase III clinical trial of multi-drug adjuvant chemotherapy for osteosarcomas (The Japan Clinical Oncology Group (JCOG) 0905) since 2010.
2) A multi-institutional phase III clinical trial of multi-drug adjuvant chemotherapy for osteosarcomas (JCOG 1306) since 2014.
3) A multi-institutional phase III clinical trial of preoperative denosumab for giant cell tumors (JCOG 1610) since 2017.
Education
We have been engaging in several educational lectures for the medical staff to promote the importance of rehabilitation for cancer treatment. We also provide instructive lectures for the medical staff of the community.
Future prospects
The recent evolution of cancer treatment increases the demand for orthopedic care and rehabilitation of cancer survivors. We must consistently focus on standardization for the methodology of rehabilitation for all cancer patients, which will be beneficial for the augmentation of the quality of life for cancer patients.