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Precision is important in the preparation of liquid mixtures of cancer chemotherapeutic agents because the clinically achievable dose levels of these agents are determined by the weight, body surface area and renal function of patients. We devised a checking procedure to determine if preparation was being done precisely. It involves measurement of the weights of vials and ampules before and after preparation of the drugs and then comparing the net weight difference with the theoretical weight difference. The theoretical weight difference is calculated from the preparation amount and specific gravity of the liquid cancer chemotherapeutic agent and the residual amount in the needle used for preparation. Through this checking procedure, we were able to determine that the net weight difference was outside the tolerance level when it varied by +4% or -8% from the theoretical weight difference. As the procedure requires only an electronic weighing machine and a preparation calculation sheet we created using the Microsoft Excel computer program, its use would be inexpensive. Though the increase in preparation time due to the procedure was significant, it was actually not so great. We therefore consider it to be a useful means of checking precision in the preparation of liquid cancer chemotherapeutic agents.

Gefitinib is administered daily for the treatment of non-small-cell lung cancer. Gefitinib treatment is often discontinued, however, because of associated adverse reactions such as skin rashes and hepatic disorder. In the present study, we surveyed the implementation status of non-daily administration of gefitinib to control associated adverse reactions particularly at Nagara Medical Center. Of 56 patients treated with gefitinib from March 2005 to May 2011, 21 received non-daily administration of gefitinib. The non-daily administration method used most frequently was once every 2 days. Of the 21 patients who received non-daily administration of gefitinib, 18 could continue treatment because the associated adverse reactions were controlled. The most common reasons for complementation with non-daily administration were hepatic disorder, anorexia, and dermatitis. Of the 6 patients who received non-daily administration of gefitinib because of hepatic disorder, 5 could continue treatment because hepatic disorder was controlled. The levels of aspartate aminotransferase and alanine aminotransferase were significantly lower during non-daily administration than during daily administration of gefitinib. Control of adverse reactions was essential for the continuation of gefitinib treatment over a long period of time. Therefore, non-daily administration of gefitinib is considered a useful treatment option for the control of adverse reactions induced by gefitinib.