Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.
UCIBIO/REQUIMTE, MedTech-Laboratory of Pharmaceutical Technology, Department of Drug Sciences, Faculty of Pharmacy, University of Porto, Porto, Portugal.
J Oncol Pharm Pract. 2020 Oct;26(7):1703-1714. doi: 10.1177/1078155220936341. Epub 2020 Jul 7.
Chemo and targeted anticancer therapies present significant skin adverse reactions, which impair the patients' quality of life. Cutaneous toxicities lead to poor treatment adherence, drug cessation, and psychosocial distress. This review aims to summarize the current knowledge concerning the prevention and management of skin toxicity arising from these therapies. A systematic literature search on online databases was conducted. The categorization of the main preventive and treatment measures was performed according to the level of evidence. Management of skin adverse reactions of oncology treatments is very heterogeneous, which can be explained by the lack of sound evidence-based treatments. The most studied adverse effects are papulopustular eruption, xerosis, and hand-foot syndrome. Prevention of xerosis stands out as the strategy most supported by level II studies. With respect to treatment, the use of antibiotics in papulopustular eruption resulting from anti-epidermal growth factor receptor agents is the most evidence-based approach. In general, the number of studies published in the literature classified with a level II of evidence (52%) is similar to the ones classified as level IV (33%), making clear the need of more randomized controlled trials regarding the effectiveness of preventive and treatment measures of skin adverse reactions of chemo and targeted anticancer therapies.
化疗和靶向抗癌治疗会引起显著的皮肤不良反应,从而降低患者的生活质量。皮肤毒性会导致治疗依从性差、药物停用和心理社会困扰。本综述旨在总结目前关于预防和管理这些治疗方法引起的皮肤毒性的知识。我们在在线数据库上进行了系统的文献检索。根据证据水平对主要预防和治疗措施进行了分类。肿瘤治疗的皮肤不良反应的管理非常多样化,这可以用缺乏合理的基于证据的治疗来解释。研究最多的不良反应是丘疹脓疱性皮疹、干燥和手足综合征。预防干燥症是最受 II 级研究支持的策略。至于治疗,在表皮生长因子受体拮抗剂引起的丘疹脓疱性皮疹中使用抗生素是最有循证依据的方法。一般来说,文献中发表的 II 级证据分类的研究数量(52%)与 IV 级证据分类的研究数量(33%)相似,这清楚地表明需要更多关于化疗和靶向抗癌治疗皮肤不良反应的预防和治疗措施有效性的随机对照试验。