/

1998 80%/ 21998 47%/ 2

1991-93100% 1991-93 71% 1985-86 69%

2000 53%

1998 39%

Bruera E, Suppt Care Cancer 1996, Chiu TY, Suppt Care Cancer, Oh DY, Cancer 2004,1999, Peteet JR, JPEN 1981, Burge FI, Can Fam Physician 199050

30-35mL/kg

*: Harris-Benedict1000-1500kcal/

JvKPcPipJv:KfPcPip

Journal of Palliative Medicine

1-2160-170cm50-60kg60

Quality of life

Metoclopramide Medroxyprogesterone acetateSteroids

1-2160-170cm50-60kg60

Quality of life

Palliative Prognostic ScorePaP score1-28.53-46.05-64.57-102.511-122.0>120KPS10-202.5>3001.51.0>110001.58501-110000.50-11.9%2.512-19.9%1.0Maltoni M. J Pain Symptom Manage 17:240-247, 199930(95%)

0-5.5>70%(67-875.6-1130-70%(28-39)11.1-17.5

Palliative Prognostic Index (PPI)

Palliative Performance Scale 10-204.030-502.5>600

()2.5()1.00

1.03.5)4.06: 3 80%Morita T. Support Care Cancer 7:128-133, 1999

PSKarnofsky Performance Scale

Performance Status (EORTC)5050Karnosfky Performance Status

Palliative Performance Scale

Palliative Performance StatusPPS)

1-2160-170cm50-60kg60

Quality of life

5000QOL QOL108Miyashita M, Morita T, Uchitomi Y et al. Ann Oncol (in press)

1-2

15

1A

B

C

D

E

VS (

Morita T. J Pain Symptom Maage 2006; 31: 130-9

n=22)(n=32)27%16%0.3241%35%0.6927%13%0.2918%3.2%0.15

Morita T. Support Care Cancer. 2002;10:44-50.

VS (

Performance Status

Performance Status

Performance status

R010-012QOL R020-022 R030-033R040-042 R050-051 R060 R070-073R080-081R090-092R100R110-111R120-121R130

R200R201R202R203R204R205R206R207R20824R209

R300-301R302-303 R304R305

R010-012QOL R020-022 R030-033R040-042 R050-051 R060 R070-073R080-081R090-092R100R110-111R120-121R130

010-012QOL RationalePS340well-being511000mLwell-being 0-10overall benefits(1-7)Bruera E. J Clin Oncol 2005; 23: 2366-2371Karnofsky Performance Status 40QOL

83%33%.00582%50%.2183%47%.03554%62%.77Well-being1.44.10.83.1.30Overall benefits3.82.23.62.0.20

010-012QOLRecommendations R0101-2Performanse Status02QOL1000-1500mL/400-600kcal/0g/1500L/1000kcal/5g/2000mL/800kcal/0g/2000mL/1600kcal/10g/R0111-2Performanse Status34QOL1000-1500mL/400-600kcal/0g/D1000-2000mL/800-1600kcal/5-10g/R0121-2Performanse Status34QOL1000-1500mL/400-600kcal/0g/1000-2000mL/800-1600kcal/5-10g/

R010-012QOL R020-022 R030-033R040-042 R050-051 R060 R070-073R080-081R090-092R100R110-111R120-121R130

020-022 RationaleP=0.006P=0.005Morita T. Ann Oncol. 2005; 16: 640-7. 131L/;591671000L1000/

020-022 Recommendations R0201-2500/500-1000/

R0211-2500-1000/

R0121-22000mL/1000mL/

R010-012QOL R020-022 R030-033R040-042 R050-051 R060 R070-073R080-081R090-092R100R110-111R120-121R130

030-033 Rationale 1000ml/ Cerchietti L. Int J Palliat Nurs. 2000; 6: 370-4. .

R0321-500-1000 mL/2000 mL/

R0301-21000mL/2000 mL/

R0311-2500-1000 mL/2000 mL/

R0331-22500mL/1000 mL/1000-1500 mL/ 030-033 Recommendations

R010-012QOL R020-022 R030-033R040-042 R050-051 R060 R070-073R080-081R090-092R100R110-111R120-121R130

040-042 Rationale 3 McCann RM. JAMA. 1994; 272: 1263-6)

1000Cerchietti L. Int J Palliat Nurs. 2000; 6: 370-432ANP Morita T. Support Care Cancer 2001; 9: 177-86)

.

040-042 Recommendations R0401-1000-1500/

R0411-500-1000/

R0421-500-1000/1000/2000mL/

R200R201R202R203R204R205R206R207R20824R209

R300-301R302-303 R304R305

10 R209 cevimeline

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Movie

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R010-012QOL R020-022 R030-033R040-042 R050-051 R060 R070-073R080-081R090-092R100R110-111R120-121R130

050-051 Rationale 1000LMorita T. Ann Oncol. 2005; 16: 640-7. 131L/;591671000/

050-051 Recommendations R05012B5001000mL/

R05122000mL/5001000mL/B

R010-012QOL R020-022 R030-033R040-042 R050-051 R060 R070-073R080-081R090-092R100R110-111R120-121R130

060 Rationale 1500mL/1000mL/

Morita (1999)n=90 vs 811500/2001n=241 vs 1111300/Morita (2003)n=226800/

060 Recommendations R060500mL/

R010-012QOL R020-022 R030-033R040-042 R050-051 R060 R070-073R080-081R090-092R100R110-111R120-121R130

070-073 Rationale

MethadoneMercadante S. J Clin Oncol 2001; 19: 2898-2904Ripamonti C. J Clin Oncol 1998; 16: 3216-3221Fitzgibbon DR. Pain 1997; 73: 259-261Galer BS. Pain 1992; 49: 87-91FentanylPaix A. Pain 1995; 63: 263-269Morita T. J Pain Symptom Manage 2005; 30: 96-103OxycodoneMaddocks I. J Pain Symptom Manage 1996; 12: 182-189

070-073 Recommendations R070

R0711000mL/

R0721-1000mL/

R0731-1000mL/

070-073 Rationale

Cerchietti (2000)n=521000/MMSEBruera (2005)n=511000/well-being33 vs 88)47% vs 83%)Morita (2003)n=226Lawlor (2000)n=104

070-073 Recommendations R070

R0711000mL/

R0721-1000mL/

R0731-1000mL/

R010-012QOL R020-022 R030-033R040-042 R050-051 R060 R070-073R080-081R090-092R100R110-111R120-121R130

080-081 RationalePS340511000mL0-10Bruera E. J Clin Oncol 2005; 23: 2366-2371Karnofsky Performance Status 40

54%62%.77Well-being1.44.10.83.1.30Overall benefits3.82.23.62.0.20

080-081 Recommendations R0801-2Performanse Status021000-2000mL/B

R0811-2Performanse Status341000-1500mL/

R010-012QOL R020-022 R030-033R040-042 R050-051 R060 R070-073R080-081R090-092R100R110-111R120-121R130

090-092 Rationale 1000L1000 ml1000 ml

Morita T. Support Care Cancer. 2002; 10: 474-9. 131L/;591671000/

090-092 Recommendations R0901000L/

R0911000L/

R092

R010-012QOL R020-022 R030-033R040-042 R050-051 R060 R070-073R080-081R090-092R100R110-111R120-121R130

100 Recommendations R100

100 5

45

L/

24G

15001000ml/

R010-012QOL R020-022 R030-033R040-042 R050-051 R060 R070-073R080-081R090-092R100R110-111R120-121R130

110-111 Rationale QOL1-Karnofsky Performance Status40-60Performance scale230-35mL/kg Performance scale3)

110-111Recommendations R1101-2Performanse Status021000-1500mL/400-600kcal/0g/1500L/1000kcal/5g/2000mL/800kcal/0g/2000mL/1600kcal/10g/

R1111-2Performanse Status34500-1000mL/200-400kcal/0g/1000mL/800kcal/5g/2000mL/800kcal/0g/2000mL/1600kcal/10g/

R010-012QOL R020-022 R030-033R040-042 R050-051 R060 R070-073R080-081R090-092R100R110-111R120-121R130

120-121 Rationale

30-35mL/kg

1000mL

120-121 Recommendations R1201-2500-1000mL/200-400kcal/0g/1000mL/800kcal/5g/2000mL/800kcal/0g/2000mL/1600kcal/10g/

R1211-2500-1000mL/200-400kcal/0g/2000mL/800kcal/0g/1000mL/800kcal/5g/2000mL/1600kcal/10g/

R010-012QOL R020-022 R030-033R040-042 R050-051 R060 R070-073R080-081R090-092R100R110-111R120-121R130

130

50mL1000mL / Chiu TY. Support Care Cancer. 2002; 10: 630-6. Cerchietti L. Int J Palliat Nurs. 2000; 6: 370-4

130Recommendations R130

R200R201R202R203R204R205R206R207R20824R209

R300-301R302-303 R304R305

5000QOL QOL108Miyashita M, Morita T, Uchitomi Y et al. Ann Oncol (in press)

Rationale

PCU

PCUMiyashita M et al: J Palliat Med 2004; 7: 683-693Morita T et al. J Pain Symptom Manage 2006; 31: 306-31650253550

Rationale Morita T. Am J Hospice Palliat Care 16: 509-516, 1999

R200

possibility

5000QOL QOL108Miyashita M, Morita T, Uchitomi Y et al. Ann Oncol (in press)

Communication

R200R201R202R203R204R205R206R207R20824R209

R300-301R302-303 R304R305

R203

Communication

R200R201R202R203R204R205R206R207R20824R209

R300-301R302-303 R304R305

5Rationale

PCU

PCU

5 R20

5 Communication

1

R200R201R202R203R204R205R206R207R20824R209

R300-301R302-303 R304R305

R205

Communication

Communication

R200R201R202R203R204R205R206R207R20824R209

R300-301R302-303 R304R305

R206 ()

Communication

R200R201R202R203R204R205R206R207R20824R209

R300-301R302-303 R304R305

R201

24

Communication124

R200R201R202R203R204R205R206R207R20824R209

R300-301R302-303 R304R305

R20

Communication

R200R201R202R203R204R205R206R207R20824R209

R300-301R302-303 R304R305

1000mL/R207

1000mL/ Rationale/Communication 24

R200R201R202R203R204R205R206R207R20824R209

R300-301R302-303 R304R305

R20

Communication(

R200R201R202R203R204R205R206R207R20824R209

R300-301R302-303 R304R305

R300R301

R200R201R202R203R204R205R206R207R20824R209

R300-301R302-303 R304R305

R302R303

TPNTPN

R200R201R202R203R204R205R206R207R20824R209

R300-301R302-303 R304R305

R304

R200R201R202R203R204R205R206R207R20824R209

R300-301R302-303 R304R305

?R305R306

A-1-2B-1-2C-1-2D-1-2-3E-1-2-3-4

A-112PS21cm

Recommendations and rationaleRecommendations1500mL/600kcal/0g/1500L/1000kcal/5g/2000mL/1600kcal/10g/CD2000mL/800kcal/0g/D

RationalePS

R0401000mL/R030QOL1000-1500mL/R1101000mLR021R0901500mL/R110

A-1-2B-1-2C-1-2D-1-2-3E-1-2-3-4

A-230-5012PS31cm

Recommendations and rationaleRecommendations1000mL/400kcal/0g/1000mL/800kcal/5g/2000mL/800kcal/0g/2000mL/1600kcal/10g/

Rationale

1000mLR050R090R120

A-1-2B-1-2C-1-2D-1-2-3E-1-2-3-4

B B-1 21PS4

Recommendations and rationaleRecommendations500-1000mL/200-400kcal/0g/2000mL/800kcal/0g/2000mL/1600kcal/10g/

RationalePS

R0421000mLR021R0911000mL/R031PS500-1000mL/R111

A-1-2B-1-2C-1-2D-1-2-3E-1-2-3-4

B B-23021PS4

Recommendations and rationaleRecommendationsC500-1000mL/200-600kcal/0g/D1000mL/800kcal/5g/E2000mL/800kcal/0g/E2000mL/1600kcal/10g/E

RationalePS

1000mLR050R091

R120

A-1-2B-1-2C-1-2D-1-2-3E-1-2-3-4

C C-1 2000mL/1600 kcal/, 10g/

PS 123 24

Recommendations and rationaleRecommendations500-1000L/400 kcal/, 0 g/B1000L/800 kcal/, 5 g/

Rationale2QOL

R0421000mLR022R0911000mL/R031PSR111

A-1-2B-1-2C-1-2D-1-2-3E-1-2-3-4

C C-2 301500mL/

PS 123 24

Recommendations and rationaleRecommendations500-1000mL/E

Rationale1500mL/PSQOL

1000mL(R051,R091)(R120)

A-1-2B-1-2C-1-2D-1-2-3E-1-2-3-4

D -1 1000mL/

1PS4

Recommendations and rationaleRecommendations500L/D

Rationale

A-1-2B-1-2C-1-2D-1-2-3E-1-2-3-4

D -2 1500mL/

1PS4

Recommendations and rationaleRecommendations500mL/B500mL/BDE

Rationale

500mL/R0601000mL/R051R0911500mL/R130

A-1-2B-1-2C-1-2D-1-2-3E-1-2-3-4

D -3 2000mL/1600 kcal/, 10g/

1PS4

Recommendations and rationaleRecommendations500-1000mL/C2000mL/EE

Rationale

1000mL/R022, R091500mL/R060R130

A-1-2B-1-2C-1-2D-1-2-3E-1-2-3-4

E -1

12PS3

Recommendations and rationaleRecommendations1000L/1000L/1000L/NSAIDs

RationaleR070

A-1-2B-1-2C-1-2D-1-2-3E-1-2-3-4

12PS3E -2

Recommendations and rationaleRecommendations1000L/

RationaleR071

A-1-2B-1-2C-1-2D-1-2-3E-1-2-3-4

E -3 1500mL/1500L/3000mL/

12PS3

Recommendations and rationaleRecommendations1500mL/1500L

Rationale

1000mL/R022R091 3000mL/R050R0601500mL/R110R111 R033

A-1-2B-1-2C-1-2D-1-2-3E-1-2-3-4

2000mL/1600kcal/, 10g/200300mg/dL

12PS34E -4

Recommendations and rationaleRecommendations1000-1500mL/400-600kcal/, 0g/C1000mL/800kcal/, 5g/DE Rationale

A-1-2B-1-2C-1-2D-1-2-3E-1-2-3-4

VS (

5000QOL QOL108

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