Imakata Yuko, Sugama Junko, Ichihashi Sayumi, Oohashi Fumiya, Kobayashi Masato, Oe Makoto
Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, Ishikawa, Japan.
Department of Adult Nursing, Ishikawa Prefectural Nursing University, Ishikawa, Japan.
Palliat Med Rep. 2023 Feb 20;4(1):49-55. doi: 10.1089/pmr.2022.0059. eCollection 2023.
Management of docetaxel-induced edema is important as severe edema may lead to discontinuation of chemotherapy. Patients with stage IV breast cancer (BC) treated with docetaxel have shown lower limb edema; however, details of its developmental and healing processes are unknown, and thus management strategies have not been established. The aim of this study was to investigate the characteristics of the development and healing process of docetaxel-induced lower limb edema in stage IV BC patients.
This prospective observational study was conducted on patients with BC who were administered docetaxel between September 2020 and September 2021 at a National Hospital in Japan. Skin changes such as pitting test, circumference, along with ultrasound images and subjective symptom changes were evaluated. The progression of these changes was compared between patients with stage IV and non-stage IV disease.
Five patients were enrolled in the study, of which two and one patients with stage IV and non-stage IV disease, respectively, developed lower limb edema. Early signs of lower limb edema were observed in ultrasound images, 15 cm below the peroneal head, before edema was confirmed by the pitting test and subjective symptoms. In patients with stage IV disease, edema worsened to Grade 3, and reduced four months after the end of drug administration.
For patients with stage IV disease, care should be initiated from the time the early signs are observed using ultrasound and continued for up to four months after the end of docetaxel administration.
多西他赛引起的水肿管理至关重要，因为严重水肿可能导致化疗中断。接受多西他赛治疗的IV期乳腺癌（BC）患者出现了下肢水肿；然而，其发展和愈合过程的细节尚不清楚，因此尚未确立管理策略。本研究的目的是调查IV期BC患者多西他赛引起的下肢水肿的发展和愈合过程特征。
本前瞻性观察研究针对2020年9月至2021年9月期间在日本一家国立医院接受多西他赛治疗的BC患者进行。评估了诸如压陷试验、周长等皮肤变化以及超声图像和主观症状变化。比较了IV期和非IV期疾病患者这些变化的进展情况。
5名患者纳入研究，其中分别有2名和1名IV期和非IV期疾病患者出现下肢水肿。在通过压陷试验和主观症状确认水肿之前，在超声图像中于腓骨头下方15厘米处观察到下肢水肿的早期迹象。在IV期疾病患者中，水肿恶化至3级，并在停药后4个月减轻。
对于IV期疾病患者，应从使用超声观察到早期迹象时开始护理，并在多西他赛给药结束后持续长达4个月。
