Dermatology Service, Department of Medicine, Memorial Sloan-Kettering Cancer Center, Rockefeller Outpatient Pavilion Suite 228, 160 East 53rd St, New York, NY 10022, USA.
Am J Clin Dermatol. 2013 Aug;14(4):327-33. doi: 10.1007/s40257-013-0021-0.
Anticancer therapies cause a wide range of dermatologic adverse events (AE). Although the frequency and severity of these events have been described, their effects on health-related quality of life (QoL) remain poorly understood, and the ones having a greater impact have not been ascertained.
To assess QoL in patients on conventional versus targeted anti-cancer therapies using a dermatology-specific questionnaire.
Patients (n = 283) completed the Skindex-16, a QoL questionnaire measuring the effects on three domains: symptoms, emotions, and function. Patients were grouped into two categories according to the types of oncology treatments received: (1) targeted therapies and (2) non-targeted therapies. Correlations of Skindex-16 scores with type of anti-cancer therapy, number of AEs, and specific dermatologic AEs were investigated.
Significant differences between patients treated with targeted versus non-targeted therapy with regards to total Skindex-16 (p = 0.02) and emotion subdomain (p = 0.02) scores were observed. Additionally, patients on targeted therapies experienced a significantly greater number of AEs (p < 0.001) compared with patients on non-targeted therapies. Patients who exhibited epidermal growth factor receptor (EGFR) inhibitor-induced rash had higher Skindex-16 scores (p = 0.009) and higher scores in the symptom (p < 0.001), emotion (p = 0.01), and function (p = 0.001) subdomains than patients without this AE. Similar results were observed for pruritus. All p values were two sided.
Dermatologic AEs are associated with a diminished QoL. Targeted therapies are associated with a significantly increased number of AEs and worse total and emotion Skindex-16 scores in comparison with non-targeted therapies. EGFR inhibitor rash and pruritus produced the greatest negative impact.
抗癌疗法会引起广泛的皮肤不良反应（AE）。虽然已经描述了这些事件的频率和严重程度，但它们对健康相关生活质量（QoL）的影响仍知之甚少，也尚未确定哪些影响更大。
使用皮肤科专用问卷评估接受常规与靶向抗癌治疗的患者的 QoL。
283 名患者完成了 Skindex-16 问卷，这是一种测量三个领域（症状、情绪和功能）影响的 QoL 问卷。根据接受的肿瘤治疗类型，患者分为两类：（1）靶向治疗和（2）非靶向治疗。研究了 Skindex-16 评分与抗癌治疗类型、AE 数量和特定皮肤 AE 之间的相关性。
与非靶向治疗相比，接受靶向治疗的患者在总 Skindex-16（p = 0.02）和情绪子域（p = 0.02）评分方面存在显著差异。此外，接受靶向治疗的患者发生的 AE 数量明显多于接受非靶向治疗的患者（p < 0.001）。接受表皮生长因子受体（EGFR）抑制剂诱导性皮疹的患者的 Skindex-16 评分更高（p = 0.009），且在症状（p < 0.001）、情绪（p = 0.01）和功能（p = 0.001）子域中的评分也更高，与无此 AE 的患者相比。瘙痒也观察到了类似的结果。所有 p 值均为双侧。
皮肤不良反应与 QoL 下降有关。与非靶向治疗相比，靶向治疗与 AE 数量显著增加以及 Skindex-16 总分和情绪子域评分更差相关。EGFR 抑制剂皮疹和瘙痒产生的负面影响最大。
