晚期肝癌病人標靶治療及副作用照護

Target Therapy and Healthcare Complications for Patients with Advanced-Stage Hepatocellular Carcinoma

10.6142/VGHN.33.2.141

陳怡岑(Yi-Tzen Chen)；喻絹惠(Chuan-Hui Yu)

蕾莎瓦 ； 標靶治療 ； 晚期肝癌 ； Nexavar ； Sorafenib ； targeted therapy ； advanced hepatocellular carcinoma

榮總護理

33卷2期（2016 / 06 / 01）

141 - 152

繁體中文

蕾莎瓦(Nexavar)是肝癌第三期且病人肝功能狀態良好的標準治療，目前已通過健保給付，因此使用標靶藥物治療的病人越趨於普遍。然而標靶藥物帶來的副作用，如食慾不振、手足皮膚反應、腹瀉、疲倦、皮膚疹、高血壓、掉髮、便祕、口腔黏膜炎、會陰部皮膚破損及牙齦出血等，深深困擾病人及家屬。筆者身為肝癌個管師，經常給予病人用藥前衛教、用藥後電訪或病人返診時與其會談，深深瞭解病人服用蕾莎瓦副作用發生的情形。本文彙整國內外專家學者的建議與臨床照顧病人的經驗，期望藉由介紹蕾莎瓦副作用的照護、提供正確用藥觀念，及早發現副作用及早處理，提升病人用藥遵從性，並期許提升病人的生活品質。

Nexavar is a treatment for advanced hepatocellular carcinoma patients with reserved liver function and is covered by health insurance. Therefore, an increasing number of eligible patients with unresectable hepatocellular carcinoma receive the target therapy; however, the incidences of adverse events have increased accordingly. Adverse events associated with Nexavar, include poor appetite, skin reactions on the hands and feet, diarrhea, malaise, skin rash, hypertension, hair loss, constipation, oral mucositis, genital skin erosion and gingival bleeding. These side effects are deeply troubling to patients and their families. Liver cancer case managers provide pre-medication healthcare education and post-medication telephone and return interviews to confi rm associated side effects. Through the experiences of caring for patients and the recommendations of international specialists, we integrate accurate knowledge of this medication and associated care information. We expect that early detection and intervention will enhance patient compliance with medication and improve their quality of life.

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