Rodríguez-Murphy E, Villanueva-Herraiz S, Ortega-García M P, Pérez-Feliu A, López-Montenegro Soria M A, Camps-Herrero C
Servicio de Farmacia, Consorcio Hospital General Universitario de Valencia, Valencia, España.
Farm Hosp. 2011 May-Jun;35(3):114-20. doi: 10.1016/j.farma.2010.10.004. Epub 2011 Apr 14.
To evaluate the impact and type of side-effects in patients treated with cetuximab and provide a description of the general measures and treatment.
Retrospective safety study. We included all patients that received cetuximab from January to December 2009. All information was obtained from the Pharmacy and Oncology Department's Access databases and reviewed the patient's medical history. All data was registered in an Excel workbook. Skin toxicity was graded by the current National Cancer Institute-Common Toxicity Criteria (NCI-CTC).
During the study period 43 patients received treatment with cetuximab. Acneiform eruption was present in 30 of the cases (69.8%): 14 patients with grade 1 (48.3%), 13 with grade 2 (44.8%) and 3 with grade 3 (10.3%). These adverse effects appeared in a median of seven (4-28) days. In a median of 40 (20-56) days, ten patients (23.3%) presented xerosis, and three (7%) suffered painful fissures in hands and feet after a median of 28 (21-35) days. Paronychia was present in two patients after a median of 42 (35-49) days. Finally, an alteration in hair growth was observed in two patients with overgrowth of facial hair and one patient with overgrowth of the eyelashes. Five patients presented important conjunctivitis. Three infusion reactions occurred. A grade-based treatment algorithm was used for all patients that presented cutaneous toxicity.
A considerable number of patients treated with cetuximab develop dermatological side-effects which left untreated could represent a threat to the efficacy of the therapy. Therefore effective management is mandatory, patient education and immediate treatment based on a grade-based algorithm to alleviate symptoms is necessary, so that patient compliance is guaranteed.
评估接受西妥昔单抗治疗的患者的副作用影响及类型,并描述一般措施和治疗方法。
回顾性安全性研究。纳入2009年1月至12月期间接受西妥昔单抗治疗的所有患者。所有信息均从药房和肿瘤科的访问数据库中获取,并查阅患者的病史。所有数据均记录在Excel工作簿中。皮肤毒性根据当前的美国国立癌症研究所通用毒性标准(NCI-CTC)进行分级。
在研究期间,43例患者接受了西妥昔单抗治疗。30例(69.8%)出现痤疮样皮疹:14例为1级(48.3%),13例为2级(44.8%),3例为3级(10.3%)。这些不良反应出现的中位时间为7天(4 - 28天)。中位40天(20 - 56天)时,10例患者(23.3%)出现皮肤干燥,3例患者(7%)在中位28天(21 - 35天)后出现手足疼痛性皲裂。中位42天(35 - 49天)时,2例患者出现甲沟炎。最后,2例患者出现毛发生长改变,表现为面部毛发过度生长,1例患者睫毛过度生长。5例患者出现严重结膜炎。发生3次输液反应。对所有出现皮肤毒性的患者采用基于分级的治疗方案。
相当数量接受西妥昔单抗治疗的患者出现皮肤副作用,若不治疗可能会对治疗效果构成威胁。因此,有效的管理是必不可少的,患者教育以及基于分级方案的立即治疗以缓解症状是必要的,从而确保患者的依从性。