Takeda Keiko, Shigematsu Tadashi, Shirai Masahiro, Yamagiwa Kouhei, Amamori Keiko, Sunda Kazumi, Yamanda Toshimi
Dept. of Pharmacy, Saiseikai Shigaken Hospital.
Gan To Kagaku Ryoho. 2012 Dec;39 Suppl 1:74-6.
Capecitabine, an oral prodrug of 5 -fluorouracil, is a promising treatment for colorectal, breast, and gastric cancers, but often causes hand-foot syndrome(HFS), which is the most common dose-limiting toxicity. The aim of this study was to evaluate of the efficacy of the pharmacist in providing support at ambulatory therapy centers, especially for HFS. The HFS is a higher-incidence adverse event that may develop during chemotherapy with capecitabine. Once developed, the symptoms significantly impair quality of life(QOL), leading to a reduction in the dosage or discontinuation of the treatment. Patient symptoms may therefore increase in severity. This study was performed to analyze the treatment adherence and adverse events resulting from capecitabine therapy provided by pharmacists to cancer outpatients. All patients were prescribed vitamin B6(pyridoxine), which can help to reduce or prevent HFS. A lesser or milder extent of HFS was detected in patients who had used a moisturizer at the same time as the introduction of capecitabine therapy. Adherence to this approach will benefit the patients' selfcare in maintaining moisture retention, which is an important countermeasure for HFS. Additionally, early introduction of effective countermeasures for skin care, dose reduction, and rest periods is important for HFS management; in addition, team care support is dispensable. Our support system may be useful for management strategies for HFS. We suggest that improved quality of lif e is needed in cancer outpatients being treated with chemotherapy.
卡培他滨是5-氟尿嘧啶的口服前体药物，是一种有前景的用于治疗结直肠癌、乳腺癌和胃癌的药物，但常引起手足综合征（HFS），这是最常见的剂量限制性毒性。本研究的目的是评估药剂师在门诊治疗中心提供支持的效果，尤其是针对手足综合征。手足综合征是在使用卡培他滨化疗期间可能发生的一种高发性不良事件。一旦发生，这些症状会显著损害生活质量（QOL），导致剂量减少或治疗中断。因此患者症状的严重程度可能会增加。本研究旨在分析药剂师为癌症门诊患者提供的卡培他滨治疗所导致的治疗依从性和不良事件。所有患者均被开具维生素B6（吡哆醇），其有助于减轻或预防手足综合征。在卡培他滨治疗开始时同时使用保湿剂的患者中，检测到的手足综合征程度较轻或较缓和。坚持这种方法将有利于患者在保持皮肤水分方面的自我护理，这是应对手足综合征的一项重要对策。此外，早期引入有效的皮肤护理、剂量减少和休息期对策对于手足综合征的管理很重要；此外，团队护理支持是必不可少的。我们的支持系统可能对手足综合征的管理策略有用。我们建议，接受化疗的癌症门诊患者需要提高生活质量。
