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Introduction <p>Maintaining dose intensity is essential for ensuring the efficacy of adjuvant S-1 chemotherapy in gastric cancer. Although pharmacist interventions can reduce toxicity and improve adherence, multicentre evidence regarding their impact on dose maintenance is limited.</p> Aim <p>This study aimed to evaluate the effectiveness of continuous pharmacist intervention on the eight-cycle treatment completion rate and relative performance (RP) in patients with gastric cancer undergoing outpatient S-1 adjuvant chemotherapy.</p> Method <p>This multicentre retrospective study analysed 225 patients across 12 institutions, categorised into the continuous intervention (n = 97) and non-continuous intervention (n = 128) groups. Continuous intervention was defined as systematic monitoring and management for at least 50% of the treatment duration. Inverse probability of treatment weighting was used to adjust for baseline covariates. The primary and secondary endpoints were the eight-cycle completion rate and RP value, respectively.</p> Results <p>The eight-cycle completion rate did not differ significantly between the continuous and non-continuous intervention groups (53.0% vs. 55.2%, <i>p</i> = 0.775), nor did the frequency of treatment modification events, including discontinuation or dose reduction. However, the RP value was significantly higher in the continuous intervention group than in the non-continuous intervention group (73.7% vs. 64.9%, <i>p</i> = 0.038). This finding was robustly supported by sensitivity analysis between these two groups (75.1% vs. 61.1%, <i>p</i> = 0.0008). Overall, the continuous group maintained a high intervention rate (89.1%) throughout the final cycle, providing significantly more supportive care interventions than the non-continuous intervention group (53.2% vs. 4.9%, <i>p</i> &lt; 0.001).</p> Conclusion <p>Although continuous pharmacist intervention did not improve the treatment completion rate, it was essential for maintaining RP values above the clinically essential 70% threshold through proactive toxicity management and dynamic dose optimisation. These findings suggest that systematic pharmaceutical care contributes significantly to ensuring the quality and intensity of adjuvant chemotherapy.</p>

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Effectiveness of continuous pharmacist intervention at maintaining dose intensity in postoperative adjuvant S-1 chemotherapy for gastric cancer: a multicentre retrospective study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月29日

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  • Toshinobu Hayashi,
  • Makiko Go,
  • Kenji Kawasumi,
  • Kazuyoshi Kawakami,
  • Reiko Matsui,
  • Hironori Fujii,
  • Takanori Miyoshi,
  • Tomoaki Eto,
  • Makoto Kajizono,
  • Tatsuya Ohtsubo,
  • Yumi Morioka,
  • Kyohei Yamaguchi,
  • Akihiro Ogawa,
  • Toshihisa Nakashima,
  • Maki Todo,
  • Koichi Matsuo

摘要

Introduction

Maintaining dose intensity is essential for ensuring the efficacy of adjuvant S-1 chemotherapy in gastric cancer. Although pharmacist interventions can reduce toxicity and improve adherence, multicentre evidence regarding their impact on dose maintenance is limited.

Aim

This study aimed to evaluate the effectiveness of continuous pharmacist intervention on the eight-cycle treatment completion rate and relative performance (RP) in patients with gastric cancer undergoing outpatient S-1 adjuvant chemotherapy.

Method

This multicentre retrospective study analysed 225 patients across 12 institutions, categorised into the continuous intervention (n = 97) and non-continuous intervention (n = 128) groups. Continuous intervention was defined as systematic monitoring and management for at least 50% of the treatment duration. Inverse probability of treatment weighting was used to adjust for baseline covariates. The primary and secondary endpoints were the eight-cycle completion rate and RP value, respectively.

Results

The eight-cycle completion rate did not differ significantly between the continuous and non-continuous intervention groups (53.0% vs. 55.2%, p = 0.775), nor did the frequency of treatment modification events, including discontinuation or dose reduction. However, the RP value was significantly higher in the continuous intervention group than in the non-continuous intervention group (73.7% vs. 64.9%, p = 0.038). This finding was robustly supported by sensitivity analysis between these two groups (75.1% vs. 61.1%, p = 0.0008). Overall, the continuous group maintained a high intervention rate (89.1%) throughout the final cycle, providing significantly more supportive care interventions than the non-continuous intervention group (53.2% vs. 4.9%, p < 0.001).

Conclusion

Although continuous pharmacist intervention did not improve the treatment completion rate, it was essential for maintaining RP values above the clinically essential 70% threshold through proactive toxicity management and dynamic dose optimisation. These findings suggest that systematic pharmaceutical care contributes significantly to ensuring the quality and intensity of adjuvant chemotherapy.