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紫杉烷类药物引起的指甲变化:冷冻手套和袜子预防指甲毒性的效果及其使用的预测因素。

Taxane-induced nail changes: Predictors and efficacy of the use of frozen gloves and socks in the prevention of nail toxicity.

机构信息

Istanbul University Nursing Faculty, Abide-i-Hurriyet cad., 34381 Sisli, Istanbul, Turkey.

出版信息

Eur J Oncol Nurs. 2012 Jul;16(3):270-5. doi: 10.1016/j.ejon.2011.06.007. Epub 2011 Jul 23.

Abstract

PURPOSE

The primary endpoint of this study was to determine predictors of taxane-related nail toxicity. The secondary endpoint was to evaluate the efficacy of the use of frozen gloves and socks in the prevention of taxane-related nail toxicity.

METHODS

This descriptive, interventional, cross-sectional study was conducted with 200 patients. The patients were assigned to the frozen gloves/socks intervention group or control group. Frozen gloves/socks were applied only in hourly taxane-based treatments. The Patients Record Forms of the clinic were used in data collection. Nail changes were graded using the NCI Common Toxicity Criteria for each patient and treatment. Logistic regression analysis was performed to predict the factors that affect nail changes.

RESULTS

The majority of the patients enrolled in the study were women diagnosed with breast cancer. The two groups were statistically similar for the cancer diagnosis, type and number of taxane cycles administered. Grade 1 nail toxicity was found in 34%, grade 2 in 11%, and grade 3 in 5.5% patients. Taxane-related nail toxicity was higher in patients who were female, had a history of diabetes, received capecitabine in conjunction with docetaxel and had breast or gynecological cancer diagnosis. Nail changes increased with an increase in the number of taxane cycles administered, BMI and severity of treatment-related neuropathy.

CONCLUSIONS

The multivariate analysis demonstrated that BMI, breast or ovarian cancer diagnosis and the number of taxane cycles administered were the independent factors for this toxicity. No statistically significant difference in nail toxicity incidence and time to occurrence of nail changes was found between the intervention and the control groups.

摘要

目的

本研究的主要终点是确定紫杉烷类相关指甲毒性的预测因素。次要终点是评估使用冷冻手套和袜子预防紫杉烷类相关指甲毒性的疗效。

方法

这是一项描述性、干预性、横断面研究,共纳入 200 例患者。患者被分配到冷冻手套/袜子干预组或对照组。仅在每小时进行紫杉烷类治疗时使用冷冻手套/袜子。使用诊所的患者记录表进行数据收集。每位患者和治疗的指甲变化均采用 NCI 常见毒性标准进行分级。采用逻辑回归分析预测影响指甲变化的因素。

结果

研究中纳入的大多数患者为女性,诊断为乳腺癌。两组在癌症诊断、紫杉烷类周期类型和数量方面具有统计学可比性。1 级指甲毒性发生率为 34%,2 级为 11%,3 级为 5.5%。女性、有糖尿病史、接受卡培他滨联合多西紫杉醇治疗以及乳腺癌或妇科癌症诊断的患者,紫杉烷类相关指甲毒性更高。指甲毒性随紫杉烷类周期数、BMI 和治疗相关神经病变的严重程度增加而增加。

结论

多变量分析表明,BMI、乳腺癌或卵巢癌诊断以及紫杉烷类周期数是该毒性的独立因素。干预组和对照组之间指甲毒性发生率和指甲变化发生时间无统计学差异。

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