Mrozek-Orlowski M E, Frye D K, Sanborn H M
Comprehensive Breast Care Program, Norris Cotton Cancer Center, Dartmouth-Hitchcock Medical Center, Lebanon, NH, USA.
Oncol Nurs Forum. 1999 May;26(4):753-62.
PURPOSE/OBJECTIVES: To describe the new oral chemotherapeutic agent capecitabine (Xeloda, Roche Laboratories Inc., Nutley, NJ) and key concepts driving its development and to delineate the nursing impact of patient-administered, home-based chemotherapies.
Published papers, investigational materials, package inserts, and clinical experience.
Capecitabine recently was approved to treat metastatic breast cancer refractory to paclitaxel and anthracycline-containing regimens. Efficacy has been demonstrated. However, although the current regimen is well-tolerated, > or = 40% of patients require dose modification because of grade 2 or greater toxicity, usually hand-foot syndrome or gastrointestinal symptoms.
Capecitabine frees nurses from infusion-related workload, allowing and demanding a new type and level of patient education. Such education emphasizes compliance with the treatment plan and prevention, timely recognition, and management of toxicities. These practice changes also challenge nurses to advocate for reimbursement of educational practices.
Oncology nurses will play more of a central role as use of patient-administered, home-based therapies increases. Nurses must enhance their patient-education and telephone symptom-management skills and help to secure reimbursement for such activities.
目的/目标：描述新型口服化疗药物卡培他滨（希罗达，罗氏制药公司，新泽西州纽特利）及其研发背后的关键理念，并阐述患者自行在家进行化疗所产生的护理影响。
已发表论文、研究资料、药品说明书及临床经验。
卡培他滨最近被批准用于治疗对紫杉醇和含蒽环类药物方案耐药的转移性乳腺癌，其疗效已得到证实。然而，尽管当前方案耐受性良好，但≥40%的患者因2级或更高级别的毒性（通常是手足综合征或胃肠道症状）需要调整剂量。
卡培他滨使护士从与输液相关的工作负担中解脱出来，这既要求也允许开展新型且更高水平的患者教育。此类教育强调遵守治疗计划以及对毒性的预防、及时识别和处理。这些实践变革也促使护士倡导为教育实践提供报销。
随着患者自行在家进行治疗的使用增加，肿瘤专科护士将发挥更核心的作用。护士必须提高患者教育和电话症状管理技能，并帮助确保此类活动能够获得报销。
