卡培他滨作为辅助化疗用于结直肠癌患者时手足综合征的依从性和有效管理。
Compliance and effective management of the hand-foot syndrome in colon cancer patients receiving capecitabine as adjuvant chemotherapy.
机构信息
Department of Nursing, Colorectal Cancer Center, Samsung Medical Center, Seoul, Korea.
出版信息
Yonsei Med J. 2009 Dec 31;50(6):796-802. doi: 10.3349/ymj.2009.50.6.796. Epub 2009 Dec 18.
PURPOSE
Physicians and oncology nurses must continue to update their knowledge on treatment and treatment-related side effects, while searching for effective methods to prevent or manage side effects. The objective of our study was to describe the incidence and response to treatment of the hand-foot syndrome (HFS) and the compliance with treatment of patients with stage IIB, IIIA, IIIB, and IIIC colon cancer that were treated with capecitabine alone as adjuvant therapy.
MATERIALS AND METHODS
Between September 2005 and September 2006, 84 patients fulfilled the inclusion criteria and were included in this retrospective analysis of prospectively collected data.
RESULTS
The treatment compliance rate was 90.5% (76 out of the 84 patients). The HFS developed in 65 patients (77.4%). Thirty-three patients (50.7%) had grade 1 HFS, 22 patients (33.8%) had grade 2 HFS and 10 patients (15.5%) had grade 3 HFS, as their most severe episode. For Grade 1 patients, the dose was maintained, and skin barrier cream and moist exposed burn ointment (MEBO) were applied. For Grade 2 patients, either the dose was maintained or 25% of the dose was reduced; MEBO and supportive care were provided. For Grade 3 patients, one cycle of chemotherapy was interrupted followed by dose adjustment; MEBO and supportive care were provided.
CONCLUSION
HFS is manageable if both patients and oncology care teams are educated about HFS associated with capecitabine. The HFS is treated by patient education, preventive management, ointment application, conservative management, dose reduction, and interruption of chemotherapy administration.
目的
医生和肿瘤护士必须不断更新他们对治疗和治疗相关副作用的认识,同时寻找预防或管理副作用的有效方法。我们研究的目的是描述单独使用卡培他滨作为辅助治疗的 IIB、IIIA、IIIB 和 IIIC 期结肠癌患者的手足综合征 (HFS) 的发生率和治疗反应以及治疗依从性。
材料和方法
在 2005 年 9 月至 2006 年 9 月期间,84 名患者符合纳入标准,并被纳入本前瞻性收集数据的回顾性分析。
结果
治疗依从率为 90.5%(84 名患者中有 76 名)。HFS 发生在 65 名患者(77.4%)中。33 名患者(50.7%)为 1 级 HFS,22 名患者(33.8%)为 2 级 HFS,10 名患者(15.5%)为 3 级 HFS,为最严重的发作。对于 1 级患者,维持剂量,并使用皮肤屏障霜和湿润烧伤膏(MEBO)。对于 2 级患者,要么维持剂量,要么减少 25%的剂量;提供 MEBO 和支持性护理。对于 3 级患者,一个化疗周期被中断,然后调整剂量;提供 MEBO 和支持性护理。
结论
如果患者和肿瘤护理团队都接受过有关卡培他滨相关 HFS 的教育,那么 HFS 是可以管理的。通过患者教育、预防性管理、软膏应用、保守管理、剂量减少和化疗中断来治疗 HFS。