[A case report of a patient with advanced rectal cancer who was administered chemotherapy in collaboration with a clinical pathway and visiting nursing care].

Recently, chemotherapy for the treatment of colorectal cancer was widely administered in Japan. Many various ideas were necessary to perform safe and efficient chemotherapy at our hospital. We experienced that even a patient with intellectual disability could have chemotherapy carry out smoothly in collaboration with a clinical pathway and visiting nursing care. The patient was a 63-year-old man who underwent low anterior resection of the rectum for advanced rectal cancer on April 2004. Multiple liver metastases had appeared in November 2004. Chemotherapy was administered because of the liver metastases. However, it was difficult to manage the side effect of the chemotherapy and we could not get cooperation from his family. A visiting nursing care was employed in cooperation with outpatient nursing for managing of the side effect. IFL regimen was carried out using a clinical pathway. The response became PD after 5 courses of an IFL regimen. The regimen was changed to FOLFOX4 on April 2005. No adverse events were seen beyond grade 2 during 10 courses of FOLFOX4 regimen.