Popa Cristina-Maria, Ianoşi Simona Laura, Săftoiu Adrian
PhD student, Research Center of Gastroenterology and Hepatology, University of Medicine and Pharmacy of Craiova, Romania.
Department of Dermatology, Emergency County Hospital, Craiova, Romania.
Curr Health Sci J. 2021 Oct-Dec;47(4):516-522. doi: 10.12865/CHSJ.47.04.06. Epub 2021 Dec 31.
In recent years, oncology studies have focused on molecular targeted therapy, based on the development of numerous agents with a role in inhibiting the epidermal growth factor receptor (EGFR). When overexpressed, EGFR plays an extremely important role in the growth of certain tumour cells. Compared to classical chemotherapy, the systemic adverse effects of the molecular targeted therapy are much lower. However, between 80 to 100% of the patients treated with EGFR inhibitors develop a separate class of adverse effects, namely skin reactions.
Early identification of skin toxicity, dynamic monitoring of patients during EGFRI treatment, correlation of clinical data and their management.
We conducted a prospective study from 2018 to 2021 on patients who had received any EGFRI from all over Oltenia region. We were able to identify 31 oncologic patients who had received EGFRI for metastatic colorectal cancer, lung cancer or head and neck cancer. All of them were completely dermatologically examined, dynamically monitored for each oncological cycle.
The dermatological follow-up throughout the study allowed the classification of skin toxicity according to the onset of manifestations after EGFRI treatment, the reporting of serious adverse effects and their management. Within the study group, 29 out of the 31 patients treated oncological with EGFRI therapy experienced at least one cutaneous adverse effect, the majority of which showed clinical polymorphism of lesions.
The lack of dermatological treatment often leads to dose reduction or even to the discontinuation of the cancer treatment. Severe forms were also identified and their rapid treatment allowed the continuation of the cancer therapy and increased quality of life for all patients.
近年来，肿瘤学研究聚焦于分子靶向治疗，这基于众多具有抑制表皮生长因子受体（EGFR）作用的药物的研发。当EGFR过度表达时，其在某些肿瘤细胞的生长中发挥着极其重要的作用。与传统化疗相比，分子靶向治疗的全身不良反应要低得多。然而，接受EGFR抑制剂治疗的患者中有80%至100%会出现另一类不良反应，即皮肤反应。
早期识别皮肤毒性，在EGFR抑制剂治疗期间对患者进行动态监测，关联临床数据并进行管理。
我们在2018年至2021年对来自奥尔特尼亚地区各地接受任何EGFR抑制剂治疗的患者进行了一项前瞻性研究。我们能够识别出31例接受EGFR抑制剂治疗转移性结直肠癌、肺癌或头颈癌的肿瘤患者。对所有患者进行了全面的皮肤科检查，并在每个肿瘤治疗周期进行动态监测。
在整个研究过程中的皮肤科随访使得能够根据EGFR抑制剂治疗后表现的出现情况对皮肤毒性进行分类，报告严重不良反应并进行管理。在研究组中，31例接受肿瘤EGFR抑制剂治疗的患者中有29例至少经历了一种皮肤不良反应，其中大多数表现出病变的临床多态性。
缺乏皮肤科治疗往往导致癌症治疗剂量减少甚至停药。还识别出了严重类型，对其快速治疗使得癌症治疗得以继续，并提高了所有患者的生活质量。
