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肿瘤患者皮肤不良反应的管理。

Management of skin adverse reactions in oncology.

机构信息

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.

出版信息

J Oncol Pharm Pract. 2020 Oct;26(7):1703-1714. doi: 10.1177/1078155220936341. Epub 2020 Jul 7.

DOI:10.1177/1078155220936341
PMID:32635811
Abstract

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.

摘要

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。

相似文献

1
Management of skin adverse reactions in oncology.肿瘤患者皮肤不良反应的管理。
J Oncol Pharm Pract. 2020 Oct;26(7):1703-1714. doi: 10.1177/1078155220936341. Epub 2020 Jul 7.
2
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Impact and management of skin toxicity associated with anti-epidermal growth factor receptor therapy: survey results.抗表皮生长因子受体治疗相关皮肤毒性的影响与管理:调查结果
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Targeted tumour therapy induced papulopustular rash and other dermatologic side effects: a retrospective study.靶向肿瘤治疗引起的丘疹脓疱性皮疹及其他皮肤副作用:一项回顾性研究
Cutan Ocul Toxicol. 2019 Sep;38(3):261-266. doi: 10.1080/15569527.2019.1594874. Epub 2019 May 7.
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Skin Manifestations of Targeted Antineoplastic Therapy.靶向抗肿瘤治疗的皮肤表现
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The spectrum of cutaneous toxicities related to novel genitourinary cancer therapies.新型泌尿生殖系统癌症治疗相关的皮肤毒性谱。
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Predictors of Tumor Response to Cetuximab and Panitumumab in 116 Patients and a Review of Approaches to Managing Skin Toxicity.116例患者中肿瘤对西妥昔单抗和帕尼单抗反应的预测因素及皮肤毒性管理方法综述
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Clinical management of cutaneous adverse events in patients on targeted anticancer therapies and immunotherapies: a national consensus statement by the Spanish Academy of Dermatology and Venereology and the Spanish Society of Medical Oncology.靶向抗肿瘤治疗和免疫治疗患者皮肤不良反应的临床管理:西班牙皮肤病学会和性病学会与西班牙肿瘤内科学会的国家共识声明。
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引用本文的文献

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Management of Skin Toxicities in Cancer Treatment: An Australian/New Zealand Perspective.癌症治疗中皮肤毒性的管理:澳大利亚/新西兰视角
Cancers (Basel). 2024 Jul 12;16(14):2526. doi: 10.3390/cancers16142526.
2
Dermatological Side Effects of Cancer Treatment: Psychosocial Implications-A Systematic Review of the Literature.癌症治疗的皮肤副作用:社会心理影响——文献系统综述
Healthcare (Basel). 2023 Sep 25;11(19):2621. doi: 10.3390/healthcare11192621.
3
Experience of patients with lung cancer and with targeted therapy-related skin adverse drug reactions: A qualitative study.
肺癌患者及靶向治疗相关皮肤药物不良反应的经验:一项定性研究。
Asia Pac J Oncol Nurs. 2022 Jul 6;9(10):100115. doi: 10.1016/j.apjon.2022.100115. eCollection 2022 Oct.
4
Identification of hand-foot syndrome from cancer patients' blog posts: BERT-based deep-learning approach to detect potential adverse drug reaction symptoms.基于 BERT 的深度学习方法从癌症患者的博客文章中识别手足综合征:检测潜在药物不良反应症状。
PLoS One. 2022 May 4;17(5):e0267901. doi: 10.1371/journal.pone.0267901. eCollection 2022.
5
The relationship between medication literacy and skin adverse reactions in non-small-cell lung cancer patients undergoing targeted EGFR-TKI therapy.接受靶向 EGFR-TKI 治疗的非小细胞肺癌患者的药物使用素养与皮肤不良反应之间的关系。
BMC Cancer. 2022 May 3;22(1):491. doi: 10.1186/s12885-022-09599-w.
6
An Emollient PLUS Balm Is Useful for the Management of Xerosis in Patients Treated for Cancer: A Real-World, Prospective, Observational, Multicenter Study.一种润肤加软膏对癌症治疗患者皮肤干燥症的管理有用:一项真实世界、前瞻性、观察性、多中心研究。
Dermatol Ther (Heidelb). 2022 Mar;12(3):683-699. doi: 10.1007/s13555-022-00685-2. Epub 2022 Feb 2.