Grenon Nina N
Dana-Farber Cancer Institute, Boston, MA, USA.
Clin J Oncol Nurs. 2013 Aug 1;17(4):425-33. doi: 10.1188/13.CJON.425-433.
Toxicities commonly associated with antiangiogenic agents include hypertension, proteinuria, wound-healing complications, bleeding or hemorrhage, thromboembolic events, hypersensitivity reactions, and gastrointestinal perforation; however, toxicities most often attributed to chemotherapy include nausea, vomiting, diarrhea, constipation, fatigue, neuropathy, mucositis, hand-foot syndrome, hypersensitivity reactions, and myelosuppression. Patients with metastatic colorectal cancer (mCRC) who receive an antiangiogenic agent in combination with chemotherapy may experience toxicities related to both chemotherapy and the antiangiogenic agent. If possible, evidence-based interventions should be used for the management of toxicities. Patient education about expected toxicities and optimal toxicity management can promote the optimal use of therapy to improve survival and quality of life. Oncology nurses are well positioned to educate patients and their families on anticipated treatment and management of side effects. This article summarizes the incidence of toxicities associated with the antiangiogenic biologic agents aflibercept and bevacizumab, in combination with chemotherapy for patients with mCRC, and provides strategies for managing these toxicities based on clinical practice guidelines.
与抗血管生成药物常见相关的毒性包括高血压、蛋白尿、伤口愈合并发症、出血或大出血、血栓栓塞事件、过敏反应以及胃肠道穿孔；然而，最常归因于化疗的毒性包括恶心、呕吐、腹泻、便秘、疲劳、神经病变、黏膜炎、手足综合征、过敏反应以及骨髓抑制。接受抗血管生成药物联合化疗的转移性结直肠癌（mCRC）患者可能会出现与化疗和抗血管生成药物相关的毒性。若有可能，应采用基于证据的干预措施来管理毒性。对患者进行关于预期毒性和最佳毒性管理的教育，可促进最佳治疗的使用，以提高生存率和生活质量。肿瘤学护士在教育患者及其家属关于预期治疗和副作用管理方面具有良好的条件。本文总结了与抗血管生成生物制剂阿柏西普和贝伐单抗联合化疗用于mCRC患者相关的毒性发生率，并根据临床实践指南提供了管理这些毒性的策略。
