Center for Melanoma, Massachusetts General Hospital Cancer Center, 55 Fruit Street, Yawkey Building Suite 9E, Boston, MA 02114, USA.
Support Care Cancer. 2012 Aug;20(8):1601-11. doi: 10.1007/s00520-012-1473-0. Epub 2012 May 5.
The aim of this review was to examine the toxicity profile of adjuvant interferon (IFN) alfa-2b in melanoma patients from a nursing perspective and to summarize practical information to guide the effective management of common IFN toxicities to improve patient comfort.
This is a narrative summary of both research and review articles identified by searching PubMed, National Cancer Institute, and American Cancer Society websites. It also assesses recognized guidelines on the management of adjuvant IFN toxicity relevant to nurses who are caring for patients receiving adjuvant IFN therapy.
Adjuvant high-dose IFN alfa-2b (HDI) as compared with observation significantly prolongs relapse-free survival in patients with melanoma at high risk for recurrence after surgical resection; however, treatment compliance and patient quality of life can be compromised by its toxicity profile. HDI toxicities affect a number of organ systems and the majority of patients will experience some side effects. Common toxicities such as flu-like symptoms, fatigue, anorexia, neuropsychiatric symptoms, and laboratory abnormalities are discussed, along with both pharmacological and nonpharmacological management strategies.
The considerable side effects of HDI can be managed using established strategies. Oncology nurses play a significant role in the management of patients with melanoma receiving adjuvant HDI, and their prompt recognition of side effects, together with an understanding of effective pharmacological and nonpharmacological interventions, will improve patient comfort; this has the potential to positively influence treatment adherence and completion of the recommended treatment course.
本综述旨在从护理角度检查辅助干扰素 (IFN) alfa-2b 在黑色素瘤患者中的毒性概况，并总结实用信息以指导常见 IFN 毒性的有效管理，从而提高患者的舒适度。
本文是对通过搜索 PubMed、美国国家癌症研究所和美国癌症协会网站检索到的研究和综述文章的叙述性总结。它还评估了与护理接受辅助 IFN 治疗的患者相关的辅助 IFN 毒性管理的公认指南。
与观察相比，辅助高剂量 IFN alfa-2b (HDI) 可显著延长手术切除后有高复发风险的黑色素瘤患者的无复发生存期；然而，其毒性特征可能会影响治疗依从性和患者的生活质量。HDI 毒性会影响多个器官系统，大多数患者会出现一些副作用。本文讨论了常见的毒性，如流感样症状、疲劳、厌食、神经精神症状和实验室异常，以及药理学和非药理学管理策略。
可以使用既定策略来管理 HDI 的严重副作用。肿瘤护士在管理接受辅助 HDI 的黑色素瘤患者方面发挥着重要作用，他们及时识别副作用，并了解有效的药理学和非药理学干预措施，将提高患者的舒适度；这有可能积极影响治疗依从性和完成推荐的治疗疗程。
