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表皮生长因子受体(EGFR)抑制剂相关的皮肤毒性:临床心理学家的观点。对健康相关生活质量的影响以及心理后遗症临床管理的意义。

Dermatologic toxicities associated with EGFR inhibitors: the clinical psychologist's perspective. Impact on health-related quality of life and implications for clinical management of psychological sequelae.

作者信息

Wagner Lynne I, Lacouture Mario E

机构信息

Center on Outcomes, Research and Education, Evanston Northwestern Healthcare, Northwestern University, Feinberg Medical School, Chicago, IL 60611, USA.

出版信息

Oncology (Williston Park). 2007 Oct;21(11 Suppl 5):34-6.

Abstract

Dermatologic toxicities associated with EGFR inhibitors can have a profound impact on patients' health-related quality of life (HRQL) and may interfere with treatment adherence. We interviewed 20 patients and 12 expert clinicians to identify the most bothersome aspects of dermatologic toxicities to better understand the impact on patients' HRQL Patients and expert clinicians reported that dermatologic toxicities have an impact on patients' physical, functional, emotional, and social well-being. Patients identified the physical discomfort as having the most impact on their HRQL, specifically the sensations of pain, burning, and skin sensitivity. Patients experienced worry, frustration, and depression because of their dermatologic symptoms and reported withdrawing from social activities. Cognitive behavioral strategies such as guided imagery and symptom reframing (eg, rash means treatment is working) may provide patients with valuable skills for the management of this physical discomfort. Cognitive behavioral strategies may also be useful in helping patients manage anxiety and depression associated with any changes in their social function caused by skin rash, as well as distress associated with having a cancer diagnosis.

摘要

与表皮生长因子受体(EGFR)抑制剂相关的皮肤毒性会对患者的健康相关生活质量(HRQL)产生深远影响,并可能干扰治疗依从性。我们采访了20名患者和12名专家临床医生,以确定皮肤毒性最困扰人的方面,以便更好地了解其对患者HRQL的影响。患者和专家临床医生报告称,皮肤毒性会对患者的身体、功能、情感和社会福祉产生影响。患者认为身体不适对其HRQL影响最大,尤其是疼痛、灼烧感和皮肤敏感性。患者因皮肤症状而感到担忧、沮丧和抑郁,并报告退出社交活动。认知行为策略,如引导式意象和症状重构(如皮疹意味着治疗有效),可能为患者提供应对这种身体不适的宝贵技能。认知行为策略也可能有助于患者应对与皮疹引起的社交功能变化相关的焦虑和抑郁,以及与癌症诊断相关的痛苦。

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